Team Lead – Prior Auths, Insurance Verification

🕒 Ontem

☕ Washington – Remoto

☕ Washington – Remote

💵 $25 / hora

⏰ Tempo Integral

🟠 Sênior

🔒 Seguros

Candidatar-se

Encontrar Vagas Remotas Similares

Receber Emails de Vagas Remotas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

GetixHealth

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2012

☁️ SaaS

🤝 B2B

💰 Private Equity Round - Getix em 2015-01

SaaS • B2B

A GetixHealth é uma empresa de gerenciamento de ciclo de receita em saúde que oferece suítes de software baseadas em SaaS e serviços dedicados a hospitais, grupos de médicos e parceiros do setor. Suas soluções abrangem acesso de pacientes, elegibilidade e inscrição, compensação de trabalhadores, resolução de seguros, codificação e auditorias de prontuários, faturamento de auto-pagamento e serviços profissionais de RCM voltados para melhorar o desempenho financeiro, a produtividade e a experiência do paciente. A GetixHealth faz parceria com grandes sistemas e provedores de saúde para automatizar e integrar fluxos de trabalho do ciclo de receita e otimizar a cobrança e operações.

Descrição

• Review self-pay accounts to verify insurance coverage. • Analyze and resolve unpaid claims. • Contact insurance carriers for claim status and payments. • Research claims using online tools. • Gather and submit supporting documentation to insurance carriers. • Submit appeals when necessary. • Review and apply contractual terms. • Communicate with patients/guarantors to expedite claims. • Assist with special projects and additional duties as needed. • Ensure compliance with information security policies. • Monitor inventory and provide reporting on open claims. • Report security risks as per procedures.

🎯 Requisitos

• 7+ years’ experience in a facility setting performing insurance follow-up/ denials management • Knowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of Benefits • Complete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelines • Knowledge of Commercial, Governmental and third-party denials and appeals processes • Knowledge of billing systems • Must have effective organizational skills and a high attention to detail • Medical terminology required • Must demonstrate the ability to adapt to change, maintain professionalism in challenging situations, and work in a Business professional environment • Medi-Cal knowledge a major benefit • High school diploma or college degree from an accredited college or university

🏖️ Benefícios

• Comprehensive Health Coverage: Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment. • Life and Disability Insurance: Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D. • 401(k) Retirement Savings Plan: Eligible to participate in the company’s 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service. • Paid Time Off (PTO): Accrue Paid Time Off starting on your first day of employment. • Flexibility in Benefits: The company reserves the right to amend, modify, or terminate any benefits programs as needed.