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Form of workReliant is seeking a Pre-Claim Reviewer to join our remote team.
The Pre-Claim Review Team Member is responsible for reviewing, preparing, organizing, uploading, submitting Palmetto charts into eServices for the purpose of the Review Choice Demonstration. The PCR team ensures that timely submission is in place and follows up on any denied/non-affirmed cases. In addition, the Pre-Claim Review Team member is responsible for accurate submissions, prompt attention to rejections, and can problem-solve/take initiative to fix denied submissions.
About Reliant at Home
Reliant at Home is a multi-site Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas – including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.
Join Reliant at Home’s winning culture! Named to Fortune’s Best Workplaces for Aging Services in the Nation in 2020-2021 and 2022-2023. Reliant at Home has earned Great Place to Work certifications in 2020-2021, 2021-2022, and 2022-2023.
Pre-Claim Reviewer Job Responsibilities
- Responsible for preparing, organizing, submitting all Palmetto payor patients billing episodes into eServices. Ensures compliance with all State and Federal regulations prior to submission.
- Meets daily and weekly quota of chart submissions.
- Stay current on rules and regulations relevant to coding and OASIS.
- Coordination and communication with Director of Quality and Education and Pre-Claim Review Manager for identified issues.
- Demonstrates knowledge of CMS and state regulations that apply to Home Health and all other regulatory requirements.
- Update PCR dashboard without error.
- Independently follow-up on any and all denial letters/submissions.
Benefits:
- Growing company with a strong future
- Amazing team with a positive company culture
- Competitive base pay with bonus potential based on growth
- Medical, vision, and dental insurance
- Health Savings Account available with company contribution
- Paid Holidays, Vacation, and 401k with company match
- Mileage reimbursement for business-related travel
