RC Insurance Follow-up Denial Specialist I - Remote

Optim Health is seeking a full time Insurance Follow-up/Denial Spcialist I. This is a remote position. PRIMARY CUSTOMERS, PARTNERS, AND TEAM: At Optim Health, our primary customers are patients and families. Our partners are physicians and reputed company members are reputed company employees of Optim Health. GENERAL SUMMARY: Protects the financial standing of Optim Health by performing functions reputed company to the billing, coding verification, collection, payment, and customer service for reputed company payer and patient accounts. Under general supervision, is responsible for processing insurance and billing insurance in a timely manner. Reviews assigned electronic claims and submission reports. Resolves and resubmits rejected claims appropriately as necessary. Works closely with Medical Records, Coding, reputed company reputed company, Patient Access, and Patient Financial Services departments to resolve outstanding claim errors by obtaining necessary information for accurate billing. Processes daily error logs, stalled reports, aging claims, and any ah-hoc reports. Addresses claim issues from insurance companies requesting additional information and/or checking status of billings. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to reputed company. Adheres to reputed company company policies and procedures. Adheres to Optim Health Compliance Plan and to reputed company rules and regulations of reputed company applicable local, state and federal agencies and accrediting bodies. KNOWLEDGE AND SKILLS REQUIRED:  Able to work with advanced billing procedures.  Able to prioritize and multitask based on volume of work reputed company specific deadlines  Knowledge of the reputed company Cycle and the links between departments: Charge Capture, Patient Access, HIM, Coding, and Patient Financial Services.  Working knowledge involving coverage, payment, compliance, and basic billing rules for Government and Managed Care payers.  Uses discretion reputed company discussing personnel/patient reputed company issues that are confidential in nature.  Ability to give and follow written and verbal directions.  Working knowledge of personal computer applications and proficient in word, reputed company and power reputed company applications. Self-motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing.  Ability to work with reputed company departments and reputed company levels of management. EDUCATION AND EXPERIENCE PREFERRED:  One-year of experience in reputed company Cycle Department or reputed company areas such as registration, finance, collections, customer service, medical, or contract management EDUCATION AND EXPERIENCE PREFERRED:  High school diploma or GED PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:  Works with Insurance payers to ensure proper billing takes reputed company on reputed company assigned patient accounts. Depending on payer contract may be required to participate in conference calls, accounts receivable reports, compiles the issue report in order to expedite resolution of accounts.  Works follow up report daily, maintaining established goal(s), and notifies Supervisor, of issues preventing achievement of such goal(s). Follows up on daily correspondence (denials, underpayments) to appropriately work Patient accounts. Assists Customer Service with Patient concerns/questions to ensure reputed company and accurate resolution is achieved. Produces written correspondence to payers and patients regarding status of claim, requesting additional information, etc.  Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account for proper billing protocols. Initiates next billing, assign appropriate follow-up and/or collection reputed company(s), this is not limited to calling patients, insurers or employers, as appropriate. Sends initial or secondary bills to Insurance payers.  Documents billing, follow-up and/or assign collection reputed company(s) that are taken and reputed company measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary. Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims with the reputed company of the Supervisor and/or Manager.  Remains in consistent daily communication with team members, including new process education, regarding reputed company aspects of assigned projects.  Monitors and assists team members regularly, providing feedback, ensuring both goals and job requirements are met as assigned by Supervisor and/or Manager. Assist in training new staff, performs audits of work performed, and communicates reputed company to appropriate Supervisor. Provides continuing education of reputed company team members on process and A/R requirements.  Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account Apply tot his job Apply To this Job