Conduct thorough investigations of billing disputes, ensuring all relevant account history, documentation, and transaction details are reviewed.
Research, evaluate, and reconcile disputes in accordance with regulatory requirements and internal policies.
Assess dispute outcomes and weigh the risk of monetary loss, including Merchant Chargebacks and Write-Offs.
Concora Credit's mission is enabling customers to Do More with Credit every day. Concora Credit is an established company with over 20 years of experience, and we're seeking someone who wants to impact the business and play a pivotal role in leading the charge for change.
Contacts insurance companies for status on outstanding claims.
Processes and follows up on appeals to insurance companies.
Works outstanding accounts receivable from assigned work queues.
US Anesthesia Partners is dedicated to providing high-quality anesthesia services. They offer equal employment opportunities to all employees and applicants.
Enters data into scheduling and billing software for all incoming surgical cases received from facilities and surgeon office staff via email, fax, or phone calls.
Identifies and resolves any discrepancies, conflicts, or missing information through communication with facilities and surgeon office staff.
Posts cases according to division specific requirements to include general patient demographics, procedure, diagnosis, location, time of case, and estimated time required for completion.
US Anesthesia Partners, Inc. provides anesthesia related services. They are committed to equal employment opportunities and value diversity.
Conduct research and provide problem-solving support to the Customer Service Department, Brokers and Sales.
Provide efficient, courteous, professional quality service to Groups, Plan personnel and Brokers/Sales in a timely manner.
Ensure compliance with organizational and regulatory requirements.
They promise to go the extra mile for their team and community. Capital Blue Cross values your professional and personal growth by investing heavily in training and continuing education.
Facilitating the analysis and research of EOB’s to problem solve outstanding accounts.
Analyze credit balances and issues refunds as necessary.
CommonSpirit Health is a healthcare organization with over 700 care sites across the U.S., offering services from clinics and hospitals to home-based and virtual care. They are committed to building healthy communities and advocating for those who are poor and vulnerable.
Unpostables management that includes researching and resolving records that have not been matched to athenaOne related charges.
Reconciliation of re-adjudicated claims/payer takebacks.
Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques as needed.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. They aim to improve patient experiences and reward doctors for delivering high-value care.
Maintains the practice management system by entering accurate data, verifying and updating insurance and claims information, handles carrier correspondence, manages EOBs, and keys payments received into the system.
Prepares, reviews, submits, and follows up with clean claims to various companies/individuals.
Collects, posts, and manages patient account payments.
US Anesthesia Partners provides comprehensive anesthesia care. They are committed to clinical excellence and outstanding patient experience.
Manages an inventory of claims to evaluate compensability/liability.
Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
Liberty Mutual strives to create a workplace where everyone feels valued, supported, and can thrive. They build an environment that welcomes diverse perspectives, embedding inclusion in their culture and everyday interactions, which includes offering comprehensive benefits and professional development opportunities.
Resolve aging AR through root cause analysis and follow up remediation actions.
Handle client and provider billing inquiry escalations
Investigate, appeal and resolve denied or underpaid claims
SonderMind is a mental health service provider aiming to provide personalized and effective mental healthcare. They combine technology and human connection to drive better outcomes through a comprehensive approach, offering therapy, medication management, meditation, and mindfulness exercises.
Maintain a working knowledge and understanding of DMEOPS CPT and ICD-10 codes.
Utilize the company billing and collections system to identify and resolve any claims that have been unpaid, short paid and/or denied.
Review EOB's and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms.
Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. They have 160 years of clinical excellence and innovation, and its vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value.
Responsible for insurance follow-up and collections, including phone calls and accessing payer websites.
Identify root cause issues for denials and coordinate with clinic and management for process improvements.
Resolve complex inventory, including payment research, and accurately document collection activity.
Anne Arundel Dermatology provides comprehensive medical, surgical, and esthetic skin care services. With over 250 clinicians and 110 locations across 7 states, they are experiencing growth and looking for talented individuals to join their team.
Process/post AR from all assigned payers within the expected Turnaround Time
Research payer websites to obtain posting backup
Communicate with leadership and partner teams to ensure accurate and timely processing of remittance
Labcorp is a leading global life sciences company that provides vital information to help doctors, hospitals, pharmaceutical companies, researchers, and patients make clear and confident decisions. They employ nearly 70,000 employees, serving clients in more than 100 countries.
Investigates new claims and gathers information regarding injuries or loss.
Manages an inventory of property/casualty and disability claims, and negotiates settlements within prescribed limits.
Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols.
Liberty Mutual strives to create a workplace where everyone feels valued and supported. They offer comprehensive benefits, workplace flexibility, and professional development opportunities, fostering an inclusive culture where employees can thrive and make a meaningful impact.
Audits client data and generates high quality recoverable claims for the benefit of Cotiviti and our clients.
Conduct advanced, strategic analysis of paid claims, uncovering critical audit insights that drive process improvements and enhance organizational knowledge.
Make determinations based on prior knowledge and experience of client contract terms with the likelihood of recovery acceptance.
Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. They are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth.
Performs research, analysis, and resolution of moderate to complex deductible and loss-billing issues.
Partners across Claims, Underwriting, Finance, IT, Helmsman and external stakeholders to drive accurate billing outcomes.
Provides guidance to less-experienced analysts and escalates larger operational issues to management.
Liberty Mutual is an insurance company. They value hard work, integrity and commitment to make things better, and they put people first by offering benefits that support life and well-being.
Involved in construction dispute resolution, claims preparation and analysis, forensic accounting, cost analysis.
Perform damages quantification, including loss of productivity analysis, prolongation costs analysis, additional work assessment.
Manage client relations, perform advanced data research, deliver on tight deadlines, prepare and make presentations.
J.S. Held is a global consulting firm providing technical, scientific, financial, and strategic expertise to advise clients seeking to realize value and mitigate risk. The firm offers a comprehensive suite of services, products, and data, enabling clients to navigate complex and catastrophic situations.
Perform quality review and evaluation of all claim submissions.
Determine the eligibility of assigned claim by applying appropriate contractual provisions.
Document rationale of claim decisions based on review of the contractual provisions.
Berkley Accident and Health designs innovative risk management solutions. They have an entrepreneurial culture with a strong emphasis on analytics, helping employers better manage their risk, and is backed by a Fortune 500 company.
Resolve aged claims and appeals via payer portals & outbound phone calls.
Prioritize assigned work queue to ensure timely work is balanced with working the most payable claims.
Work professionally with Revenue Cycle teammates to be responsive to requests that require your assistance.
CareDx, Inc. is focused on providing healthcare solutions for transplant patients and caregivers. They are the leading provider of genomics-based information for transplant patients.
Responsible for complete, accurate, and timely processing of all designated claims.
Investigates denial sources, resolves and appeals denials, which may include contacting payer representatives.
Works with internal teams and care center staff to ensure optimal revenue cycle functionality.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors. Their platform consists of scalable operations and cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.