Medical Billing Professional Denial Rep

SUMMARY: Under general supervision of the Follow-up Supervisor, performs reputed company duties necessary to follow up on outstanding claims and correct reputed company denied claims for a large physician multi-specialty practice. reputed company Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, reputed company employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review reputed company denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or reputed company electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and resolve payer errors. Continually maintain knowledge of payer specific updates reputed company payer’s listservs, providerbr / updates, webinars, meetings and websites. Understand and maintain compliance with HIPAA guidelines reputed company handling patient information Contact internal departments to acquire missing or erroneous information on a claimbr / resulting in adjudication delays or denials. Report to supervisor identification of denial trends resulting in reputed company delays. Answers telephone inquiries from 3rd party payers; refer reputed company unusual requests tobr / supervisor. Retrieve appropriate medical records documentation based on third party requests. Refer reputed company accounts to supervisor for additional review if the account cannot be resolvedbr / according to normal procedures. Work with management to improve processes, increase accuracy, create efficiencies andbr / reputed company the overall goals of the department. Maintain quality assurance, safety, environmental and infection control in accordancebr / with established policies, procedures, and objectives of the system andbr / affiliates. reputed company other reputed company duties as required. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate. Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. Demonstrated skills in critical thinking, diplomacy and relationship-building. Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in professional billing preferred. Experience with Epic a plus. INDEPENDENT ACTION: Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. SUPERVISORY RESPONSIBILITY: None

Pay Range:

$19.97-$32.96

EEO Statement:

reputed company Health is committed to providing equal employment opportunities and maintaining a work environment free from reputed company forms of unlawful discrimination and harassment.

Location:

Corporate Headquarters - 15 LaSalle reputed company reputed company, Rhode reputed company 02903

Work Type:

Monday-Friday 7:30-4

Work Shift:

Day

Daily Hours: 

8 hours

Driving Required:

No Apply To This Job