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 workplace culture that values innovation and self-motivation
- Engaging work in a fast-paced environment with a focus on critical cardiopulmonary conditions
What to Expect (Job Responsibilities):
- Research and resolve claim denials in compliance with federal, state, and payor guidelines
- Identify trends in underpayments, denials, and errors for timely resolution
- Escalate claim issues with payors and collaborate with leadership to address reimbursement obstacles
- Manage appeals, reopenings, and redeterminations based on insurance carrier requirements
- Respond to patient inquiries and process charity and payment plans following established policies
What is Required (Qualifications):
- Minimum of 3 years of experience in the medical reimbursement field
- Proficient in reading and understanding Explanation of Benefits (EOBs)
- High School Diploma or GED equivalent, with some college-level coursework
- Strong MS Excel and MS Word skills for report formatting and documentation
- Ability to communicate effectively with insurance representatives and patients
How to Stand Out (Preferred Qualifications):
- Experience with billing 1500 and UB04 claim forms
- Knowledge of non-contracted and contracted payer behaviors
- Familiarity with medical terminology and office equipment operation
- Typing speed of 45 wpm and proficiency in 10-key by touch
- Experience in managing legal/subrogation requests and coordination of benefits
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