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Denial Management Specialist - Revo Health

Revo Health
Bloomington, MN Full Time
POSTED ON 1/26/2025
AVAILABLE BEFORE 4/25/2025

Description

The Patient Financial Services Specialist is responsible for efficiently working accounts receivable for the organization.

This is a remote, full-time position working M-F during our core business hours, 8 : 00 am - 4 : 30 pm central time.

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 - to learn more click here .

    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 :

  • 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.
  • We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here : http : / / www.uscis.gov / e-verify / employees
  • This position description will be reviewed periodically as duties and responsibilities change. Essential and Additional Job Functions are subject to modification.
  • Denial Management Specialist

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