What are the responsibilities and job description for the Denial Management Specialist - Revo Health position at Revo Health?

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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Denial Management Specialist - Revo Health

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