Description:

• Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid Insurance and managed plan insurance claims

• Research, appeal, and address claim rejections, underpayments, and denials according to policy and procedure (including but not limited to rebilling, correcting coding, calling the payer or clinic, and utilizing payor portals)

• Resolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, and Medicare/Medicaid eligibility

• Identify and rectify billing issues related to updates outlined in Medicaid provider manuals and provider bulletins

• Address patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursement

• Navigate through various payer systems, provider portals, and internal applications to ensure timely and accurate claim resolution

• Demonstrate ability to build strategic business relationships with internal and external partners (i.e., the Billing & Coding Team, Registration Department, Medicare Collections Team, Credit Department, and the payer(s))

• Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims

• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and policies

Qualifications:

• Highschool Diploma or equivalent (required); Associate or Bachelor's degree (preferred)

• Proficiency in Microsoft Office tools including Excel, Word, and Outlook (required)

• Experience working with Medicaid and Medicare payers (required)

• Healthcare revenue cycle, medical billing, and collections experience (3-5 years )

Experience Level:

Expert Level

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About the Company:
TEKsystems

About TEKsystems:

• We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
• The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Company Size:
5,000 to 9,999 employees

Industry:
Staffing/Employment Agencies

Founded:
0

Website:
https://www.teksystems.com/en/