Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services.
Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference.
Record after-call actions and perform post-call analysis for the claim follow-up.
Responsible for complete, accurate and timely processing of all designated claims.
Investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.
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 for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership.
Ensure accurate Accounts Receivable positions via collections, credit, research & analysis.
Establish appropriate credit limits by analyzing DSO and external credit risk management tools.
Ensure prompt payment of assigned accounts through telephone, email, and written communication.
FUJIFILM Healthcare Americas Corporation innovates for a healthier world with cutting-edge healthcare solutions, including diagnostic imaging and in-vitro diagnostics. They have over 70,000 employees across healthcare, electronics, business innovation, and imaging, guided by their Group Purpose of “giving our world more smiles.”
Investigates and analyzes Motor Vehicle Accident accounts.
Identifies and coordinates insurance benefits, resolving outstanding balances.
Acts as a liaison between clients, attorneys, and insurance companies.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage expertise and a unified intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers nationwide.
Responsible for the accurate and timely resolution of patient accounts.
Work assigned accounts through the collections system, analyzing them for appropriate action.
Follow all third-party payer guidelines and procedures for collection; keep current on policy changes.
UChicago Medicine has been at the forefront of medicine since 1899. They provide superior healthcare, mindful that each patient is an individual, advancing medical innovation, serving the health needs of the community, and moving collective knowledge forward.
Develop and implement policies and procedures for collections to minimize bad debt.
Acumatica is a leading innovator in cloud ERP (Enterprise Resource Planning) solutions with growing businesses worldwide. Our industry-specific business management solution is engineered to address real-world needs—featuring intelligent workflows and market-leading usability. Acumatica's culture is collaborative and high-energy.
Prepare documentation, review claim history, and investigate requests.
Utilize available resources to investigate claim situations for cases.
Follow-up with responsible departments and delegated entities to ensure compliance.
Centivo is an innovative health plan for self-funded employers, aiming to provide affordable, high-quality healthcare. They work with employers ranging in size from 51 employees to Fortune 500 companies and are headquartered in Buffalo, NY with offices in New York City and Buffalo.
HYER Boots is looking for an Accounts Receivable Specialist to own and execute our day-to-day wholesale AR operations. It seems they value accuracy, follow-through, and building strong working relationships with retail partners.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Primarily processes and documents transactions on insurance accounts and interacts with insurance companies and agencies.
Communicates professionally with OHSU staff and third-party customers to ensure timely and accurate processing of account transactions.
Prioritizes assigned accounts to maximize aged AR resolution and promote and implement LEAN processes.
Oregon Health & Science University values a diverse and culturally competent workforce. They are an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.
Investigate and determine whether medical insurance claims are recoverable from a liable third party.
Communicate and negotiate with healthcare plan members, insurance adjusters, and attorneys.
Utilize computer systems to accurately document collected information.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. With over 85 health plans and 270 million lives represented, we bring together a configurable, AI-powered platform along with expertise.
Supporting collections efforts to optimize cash flow.
Carrot is a global fertility and family care platform that supports members and their families through life's moments. They are trusted by multinational employers, health plans, and health systems, offering localized support in over 170 countries and 25 languages.
Receive and resolve patient correspondence regarding insurance billing.
Answer all correspondence relating to billing questions.
Verify insurance status, eligibility and general account information.
MANA Administration provides support services for 27 physician-owned medical practices in Northwest Arkansas. Their Administrative team are independent and work together, to help their physicians and clinics provide compassionate, comprehensive, quality health care while maintaining a healthy work-life balance.
Responsible for monitoring and collection of outstanding invoices through direct contact and follow-up with each partner and client as assigned and pursuant to firm policy to ensure timely remittance.
Generate and/or revise monthly client reminder statements as outlined pursuant to firm policy and departmental procedures.
Provide reports reflecting accounts receivable analyses, DSO, potential and existing bad debt reserves, agreed upon metrics and key performance indicators based on established frequency or as requested.
Williams Lea by RRD provides business support services. They specialize in administrative support, document production, presentation design, and marketing/communications, serving legal, financial, and professional services industries with thousands of employees globally.
Auditing to ensure new provider and care center information is accurate.
Conducting Care Center audits based on the number of providers.
Identifying, monitoring, and managing denial management trends.
Privia Health is a technology-driven, national physician enablement company. They collaborate with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. Their platform is led by industry talent and cloud-based technology.
Researches requests for review of resolvable claims from providers.
Compiles information related to member appeals that request an Executive Review.
Provides copies of necessary documents and submits information to the Appeals and Policy Manager for review.
PEHP Health & Benefits is a division of the Utah Retirement Systems that serves Utah’s public employees through competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. They embrace both a public mission and a commitment to creating customer value.
Responsible for accurate and timely submission of billing claims.
Responsible for the timely follow-up of unpaid inpatient, outpatient and clinic claims.
Provides appropriate medical documentation to the insurance carrier.
Plumas District Hospital provides essential health care services to the residents of Quincy and the surrounding area. They are located in Quincy, California, nestled against the Western slope of the Sierra Nevada mountain range.
Exercises a high degree of control over confidential medical information.
Keeps current with changing billing requirements and shares pertinent information with billing team members.
Analyzes and initiates corrective action for patient claims.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. They value excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for patients and each other.
Provides billing support for the Sandstone Care billing team.
Responsible for verification of benefits, billing data, claims submission, claim corrections, claim re-submissions, claim follow up and appeals.
Generates revenue by making payment arrangements, collecting accounts, monitoring and pursuing delinquent accounts.
Sandstone Care is committed to providing accessible, affordable, and high-quality mental health and addiction treatment services. They strive to create a diverse and inclusive workplace where all employees feel valued, respected, and empowered.
Coordinate with clients to gather information for unemployment claims.
File appeals to determinations with state agencies.
Prepare and submit responses to state requests.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. As a FTSE 100 Index company, they have a team of 22,500 people across 32 countries and are listed on the London Stock Exchange (EXPN).