Employer Industry: Healthcare Software Solutions
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient outcomes and operational efficiencies
- Diverse and inclusive company culture that values innovation and self-motivation
- Experience working in a fast-paced environment with a commitment to improving lives
What to Expect (Job Responsibilities):
- Manage denial resolutions and take appropriate actions for payment within federal, state, and payor guidelines
- Identify and escalate payor or system trends leading to underpayments and claim denials
- Communicate with payors and patients to gather necessary information for claim resolution
- Process appeals, reopenings, and redeterminations as required by insurance carriers
- Respond to inquiries from patients regarding their accounts and assist with charity and payment plans
What is Required (Qualifications):
- Minimum 3 years of experience in the medical reimbursement field
- High School Diploma or GED equivalent, with some college-level courses
- Proficiency in MS Excel, MS Word, and PDF editing tools
- Ability to read and understand Explanation of Benefits (EOBs)
- Strong communication skills, both written and verbal, and the ability to interact professionally at all levels
How to Stand Out (Preferred Qualifications):
- Experience with billing 1500 and UB04 claim forms
- Knowledge of non-contracted and contracted payer behaviors
- Ability to type 45 wpm and perform 10-key by touch
- Familiarity with medical terminology and office equipment operations
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
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