Denial Management Specialist
This is a full-time position working M-F during our core business hours, 8:00 am - 4:30 pm central time out of our Bloomington location, open to remote candidates. Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed through Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions.
Essential Functions:
- Ensure professional communication with patients, clinic personnel, and outside vendors over the phone, via email or other written documentation and respond to all inquiries.
- Maintain a working knowledge of health care plan requirements and health plan networks.
- Verify and document insurance information as defined by current business practices.
- Accurately post all payments received from patients, attorney offices and/or insurance companies.
- Review Explanation of Benefits (EOB), research denials, rejections and/or excessive reductions.
- Ensure appropriate forms are used when requesting adjustments, insurance transfers or other specific account changes.
- Prepare, submit and ensure timely claim accuracy for all physician billing to third party insurance carriers either electronically or via hard copy.
- Make outbound phone calls to patients or insurance companies as follow up to unpaid, denied or rejected billing claims and document according to current policy.
- Take inbound calls from patients or insurance companies as follow up to unpaid, denied or rejected billing claims and document according to current policy.
- Review and work any credit balances to determine if patient and/or insurance company refund is applicable.
- Any and all other duties as assigned.
Education and Experience Requirements:
- High School diploma/GED or equivalent.
- Previous experience in a healthcare facility in relation to accounts receivable or billing practices preferred.
Benefits & Compensation:
Actual starting pay will vary based on education, skills, and experience. We offer a comprehensive Medical, Dental & Vision Plan, Maternity Bundle, 401K with Profit Sharing, Tuition Reimbursement, Gym & Car Rental Discounts.
Essential Requirements:
- Ability to comply with company policies, procedures, practices and business ethics guidelines.
- Complete job required training.
- Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
- Demonstrate prompt and reliable attendance.
- Work in the office during business hours.
- Travel independently throughout the office (which may include movement from floor to floor); frequent bending, lifting, standing, stooping or sitting for long periods of time may be required.
- Work at an efficient and productive pace, handle interruptions appropriately and meet deadlines.
- Communicate and interact in a respectful and professional manner.
- Prioritize workload while being flexible to meet the expectations of the daily operations.
- Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions.
- Understand and execute a variety of instructions.
- Effectively operate equipment and communicate on and operate the phone system.
- Work independently with minimal supervision.
- Travel to other work locations, if required.
Performance Expectations - Revo Health's Core Values:
- Integrity: Do the right thing and take responsibility for what you do and say.
- Service: Consistently contribute to deliver an exceptional experience.
- Quality: Act with high purpose, committed effort, and skillful execution to exceed expectations.
- Innovation: Identify progressive solutions that improve service, teamwork, efficiency, and/or effectiveness.
- Teamwork: Be a part of the whole; support each other positively.
Environmental Conditions:
Office setting.
Notes:
We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.
Revo Health is an Equal Opportunity/Affirmative Action Employer and will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008.