AR Recovery/Healthcare Denials Specialist III

• Ability to use Medicare Direct Data Entry (DDE) to submit claim corrections, adjustments, and inquiries as needed

• Detailed understanding of insurance follow-up (i.e., resolving non-paid, denied, under-paid, and rejected claims) for healthcare providers

• Experience in UB04 Facility Pricing and Reimbursement variance

• Good understanding of revenue cycle

• Basic understanding of HIT systems like EPIC, Paragon, Zirmed, or other billing systems

• Problem solving / superior analytical skills

• An organized and detail-oriented aptitude

What we would like to see

• Bachelor’s or associate degree

• 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of both pricing and reimbursement variances

• 2+ years of experience with Medicare processes and systems

• Detailed knowledge of Facility Reimbursement contracts, fee schedules, reimbursement procedures

• Advanced MS Excel skills

FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.

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• Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive ’s core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities

• Support FinThrive ’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, GLBA and other laws applicable to FinThrive ’s business practices; this includes becoming familiar with FinThrive ’s Code of Ethics, attending training as required, notifying management or FinThrive ’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

Physical Demands

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations. © 2024 FinThrive . All rights reserved. The FinThrive name, products, associated trademarks and logos are owned by FinThrive or relat ed entities. RV092724TJO

finthrive.com | FinThrive Careers | FinThrive Benefits & Perks | Physical Demands

Originally posted on Himalayas

• Healthcare Denials Management
• Medical Billing Specialist
• AR Recovery
• Revenue Cycle Specialist

Source: Himalayas