Job Description

• Review contracts between hospitals and insurance carriers, model claims data, and identify lost revenue
• Contact responsible party for claim payment
• Prepare and forward claim appeal letters with supporting documentation for denial overturn
• Establish working relationships with individuals at insurance companies
• Communicate with teammates and leadership to discuss and identify trends
• Contact insurance companies via phone, email, and written appeal to recover dollars
• Perform analysis on large data sets to identify underpayment and denial trends
• Conduct research on current laws and regulations pertaining to hospital reimbursement methodology
• Contribute to client decks and weekly reports to track progress of project goals and present to leadership
• Strive to maintain a personal hourly rate by meeting project metrics and goals efficiently
• Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations
• Other duties as assigned Requirements
• Detail-oriented and organized with the ability to manage time effectively and prioritize competing tasks
• Excellent communication skills both written and verbal
• Basic to experienced knowledge of Excel
• Effective documentation skills
• Strong organizational skills
• Possesses analytical capabilities and financial acumen
• Must have private and dedicated workspace that ensures confidentiality
• Understanding of health insurance, EHR’s, EMR’s, and claims handling
• Undergraduate degree or internship in a healthcare related field preferred
• Healthcare operations experience preferred
• Understanding of auditing and reporting tools such as SQL
• Presentation skills and client relations experience a plus
• 3 + years of experience in Revenue Cycle or Healthcare Claims preferred Benefits
• health, dental, vision and life insurance upon hire
• matching 401k
• competitive salaries
• advancement opportunities
• incentive programs Apply To This Job