Healthcare Follow Up Physicians Office (Remote)

About the position

Responsibilities
• Perform advanced work related to resolving physician claim denials.
• Identify the root causes of physician payer denials and implement solutions.
• Understand procedures impacted by National Correct Coding Initiative Edits (NCCI).
• Prepare and submit appeal documentation to resolve denials.
• Collaborate on and implement initiatives to reduce denials.
• Use exceptional problem-solving and critical thinking skills to resolve accounts and meet quality and productivity standards.
• Demonstrate knowledge of state/federal billing guidelines, reimbursement methodologies, and payer policies.
• Suggest additions, revisions, or deletions to work queues and claim edits to improve efficiency.
• Identify patterns in denials and escalate to management with sufficient information for follow-up.
• Use Excel to summarize and provide detailed reporting to management and clients.
• Track and trend claim denials and underpayments to identify improvement initiatives.
• Ensure all actions are documented, appeal letters are effective, and root causes are communicated clearly.

Requirements
• 2-3 years in healthcare revenue cycle.
• HS Diploma.
• Proficiency in Excel, payer portals, and claims clearinghouses.

Nice-to-haves
• Associate or bachelor's degree preferred.

Benefits
• Medical/Dental/Vision/Life Insurance
• Paid holidays plus Paid Time Off
• 401(k) plan and contributions
• Long-term/Short-term Disability
• Paid Parental Leave
• Employee Stock Purchase Plan

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