Address
Form of work
SalaryOverview:
Responds to patient/financial responsible party calls effectively and provides exemplary customer service. Identify callers' needs; educate them on CareCentrix role in their care. Determines the acceptance of patient’s financial responsibility through claim research, plans, eligibility, notes, etc.; goal to resolve patient’s account. Identifies and escalates patient issues and concerns to the appropriate senior. Responsibilities:
#IDCC
Come join a dynamic, growing team in an innovative, game-changing, healthcare organization. CareCentrix is committed to making the home the center of patient care.
Responds to patient/financial responsible party calls effectively and provides exemplary customer service. Identify callers' needs; educate them on CareCentrix role in their care. Determines the acceptance of patient’s financial responsibility through claim research, plans, eligibility, notes, etc.; goal to resolve patient’s account. Identifies and escalates patient issues and concerns to the appropriate senior.
In this job you will:
- Ensures the coordination of invoice activities leading to timely reimbursement of receivables using available resources including databases, internet, and telephone.
- Researches and resolves denials received that have not passed payer edits and may lead to a final appeal of denied services. Requires knowledge of a variety of system applications both internal and external. Determines and initiates action to resolve rejected invoices, prepares payer corrections, and/or appeals using electronic and paper processes.
- Provides guidance, assistance, education, and communications with internal and external customers related to insurance and government payers claims processing protocols.
- Utilizes various resources to determine patient’s eligibility, benefits, and health plan confirmation. Including online payer databases, CareCentrix Eligibility platforms, and medical records that may result in provider or payer recoup/rejection activity.
- Oversees accounts receivable adjustments to resolve overpayments and payment rejections according to standard operating procedures. Analyzes and clears payment variances. May prepare adjusted and corrected bills or adjust accounts receivable entries in accordance with existing operating procedures. May include the use of special reporting.
- Evaluates, analyzes and monitors the processing of invoices and on-line notes, utilizing a Windows based data processing system. Monitors payer responses, using Microsoft Excel, Microsoft Access and other software as necessary to ensure prompt payment.
- Contacts providers, physicians, and/or patients to retrieve appropriate medical documentation to substantiate services provided and engage them in assisting CareCentrix in collecting for the payer.
- Provide payers with detailed itemization of services performed to ensure timely reimbursement.
- Review EOPs/EOMBs/EOBs for accuracy of patient responsibility.
- Provide input on accounts receivable process improvements and assisting in their implementation.
- Prepares Ad Hoc financial reports for management to use in the evaluation of accounts receivable performance.
- Participates in teleconferences covering a wide range of topics that enables the NBC to effectively collect account receivables.
- Assist Lead Collector with training of newly hired associates and re-education of collection teams as necessary.
- Acts as an information resource for hard to collect accounts and a “grey area” subject expert.
- Ensures the coordination of special handling or reconciliation of spreadsheets for national payers.
- Monitors team results to ensure they are aligned with departmental goals.
- Works with internal customers to identify issues which may result in new enhancements or platforms as necessary.
- Assures the completion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.
- Participates in special projects and performs other duties as assigned.
You should get in touch if you have:
- Requires a High School Diploma or the equivalent. Must have minimum 1 year work experience.
- Two years medical claims processing and reimbursement experience generally required. Knowledge of healthcare collection procedures and related internal and external software applications are required.
- Effective analytical, verbal and communication skills also required as well as knowledge of HIPPA, The Fair Credit and Collections Act, HCPC, CPT, ICD-9 coding, intermediate competency of Microsoft Office Applications, and mathematical calculations.
- Knowledge of Utilization Management and URAC standards. Basic competency of Microsoft office applications and mathematical calculations is required.
- Must be well organized and possess excellent time management skills.
What we offer:
- Competitive Salary Range: $17 - $20 / hour plus corporate bonus incentives
- Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
- Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
- Advancement Opportunities, professional skills training, and tuition /exam reimbursement
- PayActiv - access earned income in between pay checks
- Walgreens Discount - receive up to 25% off eligible items
- Great culture with a sense of community
CareCentrix maintains a drug-free workplace
#IDCC
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
