Hospital Claims Collections Specialist - Two Chicks With A Side Hustle

Employer: Change Healthcare

Overview of Position
Follow up and pursuit of unpaid hospital insurance accounts. Subsequent verbal resolution push and/or submission of written payer disputes/appeals of underpaid accounts and denials, as well as corrected claim submission. Provide complete and thorough account reviews and audit documentation, as well as perform appropriate action steps to pursue payments for account resolution.

What will be my duties and responsibilities in this job?

Possess and apply a thorough knowledge of pursuit of insurance hospital payments.

Note and document accounts appropriately
Request or bill corrected claims as needed
Review hospital/provider notes, payments, refunds, recoups, and articulate underpayment causes and denials with payers

Review variances and take appropriate action to engage the payers to render payment
Request and review additional hospital information as appropriate
Learn, comprehend and navigate complex hospital systems

Follow HIPAA guidelines in handling patient information
Prioritize workloads using tools and resources in the most efficient manner to produce highest levels of quality productivity leading to appropriate account resolution.

What are the requirements needed for this position?

High school diploma or GED required
Prior experience in hospital revenue cycle billing, follow-up and reimbursement.
Requires at least 2 years prior experience in the healthcare field, specific to understanding the drivers causing hospital claim non-payment and denials, and the follow up dispute resolution processes required by the various insurance carriers/payers to overturn and generate reimbursement.

What other skills/experience would be helpful to have?

Excellent knowledge of insurance industry process and procedures
Strong decision making, and problem-solving skills are needed, as well as an ability to work independently with minimal supervision.

Understanding and knowledge of CPT-4/HCPC/DRG/ICD/HCPCs, and Revenue codes
Enhanced knowledge of HIPAA privacy guidelines as well as maintaining and protecting all confidential information.
Ability to multitask and set priorities on multiple projects for the highest rate of returns.

Knowledge of Commercial, Medicare/Medicaid and Medicare/Medicaid HMO’s
Understanding of A/R projects procedures and process, and the follow up required to drive collections
Sorting and filtering in Excel skills required

APPLY HERE