Job Summary: Are you an individual who thrives in an organization that is growing and evolving? Is the word “change” not scary to you? If so, we are looking for individual such as yourself to join our team. You will be responsible for performing research on denied hospital accounts and successfully work with insurance companies via phone as well as the preparation and writing of appeal letters and the associated follow up activities in order to obtain additional reimbursement for our Clients.
Duties and Responsibilities (not limited to):
- Review accounts for balance accuracy, payer plan and financial class accuracy, billing accuracy, denials, insurance requests
- Based on the detailed finding of the denial, initiate all related and supporting documentation needed to obtain proper claim payment and/or for inclusion in the appeal letter
- Contact payers via phone on accounts to verify and document reason(s) for non or underpayments.
- Document all activity taken on an account in the patient account notes
- Responsible for maintaining inventory and that daily productivity standards of assigned accounts are met
- Identify payor issues and trends and escalate issues to Management
- Ensure compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors
KNOWLEDGE, SKILLS, ABILITIES:
- Must be able to communicate effectively and professionally with strong attention to details and problem solving both verbally and written
- Willingness to make payer phone calls along with strong telephone communication skills are required
- Ability to prioritize work and meet deadlines is required
- Ability to operate common computer systems, utilize hospital collection system and business software is required
- Intermediate knowledge of hospital billing form requirements (UB-04)
- Intermediate understanding of ICD-9/10, HCPCS/CPT coding and medical terminology
- Intermediate Microsoft Office (Word, Excel) skills
- Understanding of the revenue cycle process a plus
- Strong interpersonal skills
- Ability to be flexible and promote teamwork
- Belief in a company culture of integrity, doing the right thing and quality. Work hard and celebrate success in fun and innovative ways.
Include minimum education, technical training, and/or experience preferred to perform the job
- High School Graduate minimum education requirement, prefer college degree
- Strong analytical skills and strong proficiency in Microsoft Office Tools
- 3-5 years’ medical claims and/or acute care hospital collections experience or prior experience in similar position preferred.
- Steady prior work history with consistent employment within past positions.
Job Type – Full Time Days