Please Review:

• This is a 13 week (3 MO) contract position to start.
• Monday through Friday, Days.
• Pay is $22.00 - $22.19/HR.

Overview:

• Responsible for researching and resolving claim denials, ADR requests and certs, submitting and tracking appeals, noting trends and providing monthly reports. Responds to audit requests (including RAC) from payors.
• Maintains a Library of Payer reference material regarding requirement for pre authorization, medical necessity and documentation requirements.
• Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials.
• Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
• Analyze denied, underpaid and unpaid claims. Appeal underpaid and denied claims within timely filing periods.
• Identify, track and report on denial trends.
• Maintain an appeals data base to identify and report outcomes and opportunities
• Identify any billing and/or coding trends resulting in denials and report to the Coding manager.
• Identify any other trends resulting in denials and report to Manager.

Qualifications:

• High School Diploma/GED.
• Minimum of two years of professional billing with an emphasis in Managed Care denial follow up and appeals processing.
• Prior hospital billing experience a plus.
• Epic experience, hyperspace is preferred.
• Basic knowledge understanding of Medicare reimbursement for inpatient and outpatient claims.

#MARCUSOLIVERA

Job Types: Full-time, Contract

Pay: $22.00 - $22.19 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Hospital

Work Location: In person