- Where
- United States · Remote · Remote
- Level
- Senior
Impact you will make
Reps typically demonstrate the aptitude and ability to take on critical processes while managing quality production standards. Acts as a mentor to Rep I & Rep II associates. Responsible for managing moderately complicated insurance denials and underpayments via the Rubixis AR Follow Up software.
What you will do
Learn and understand our Rubixis platform and the various resources available
Work an assigned number of accounts from start to finish successfully, and in a timely manner
Call healthcare insurance companies, their affiliates & providers to resolve any question about contract or payment issues
Analyze contract, billing, cash costing, pricing, and collections on accounts in compliance with billing regulations, policies, and
procedures
Investigate all insurance payments that deviate from expected payment
Work collaboratively with leadership and other team members to confirm, challenge, or provide trending and solutions
What you will bring
5+ years Hospital Billing with follow up experience, with advanced knowledge of all pay or types, who will be able to manage day-to-day operational tasks associated with medical insurance billing and follow up
Knowledge of Medicare payer rules, processes, including how to interpret denial reasons, how to submit appeals to Medicare payer, and access Medicare portals
Detailed understanding of insurance follow-up (i.e., resolving non-paid, denied, under-paid, and rejected claims) for healthcare providers
Experience in UB04 Facility Pricing and Reimbursement variance
Good understanding of revenue cycle
Basic understanding of HIT systems like EPIC, Paragon, Zirmed, or other billing systems
Problem solving / superior analytical skills
An organized and detail-oriented aptitude
What we would like to see
Bachelor's or Associate degree
2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of both pricing and reimbursement variances
Detailed knowledge of Facility Reimbursement contracts, fee schedules, reimbursement procedures
Advanced MS Excel skills