• ESSENTIAL DUTIES AND RESPONSIBILITIES

  • The Specialist will monitor assigned pools and duties in Artiva, HMS, Hyland, BARRT and other host systems and applications with currency to follow up dates.
  • File appeals as needed to resolve payer denials and work with payers and monitor appeals in process. Properly track and document all denial and appeal activity.
  • Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
  • Maintain BARRT requests (Outbound/Inbound) timely. Maintain all logs, account notes and system records as assigned.
  • Review and work RAC/Government Audit accounts as needed. Monitor AB rebills that are needed on RAC accounts and post recovery or denial adjustments as needed
  • Help identify issues from denials and appeals that might be avoided on future claims. Review and analyze all denial trends and issues as assigned.

  QUALIFICATIONS

  REQUIRED EDUCATION

  • Diploma or Equivalent education

  REQUIRED EXPERIENCE

  • Minimum 1 year experience in healthcare setting with experience in medical terminology.
  • Experience in revenue cycle processes in a hospital or physician office.

  KNOWLEDGE, SKILLS, AND ABILITIES

  • Intermediate knowledge of Microsoft Office tools and/or Google platforms

Education

• High School or better