MVA/Third Party Liability Resolution Specialist I

Emploi pas sur LinkedIn

🕒 il y a 7 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟢 Junior

🚫👨‍🎓 Aucun diplôme requis

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Revco Solutions

Site WebLinkedInTous les Emplois

501 - 1000 employés

🏥 Santé

🛡️ Assurance

💼 Conseil

Healthcare • Insurance • Consulting

Revco Solutions est un fournisseur de premier plan de services de gestion du cycle de revenus, spécialisé dans le recouvrement de créances du secteur de la santé et la conformité. Avec un engagement vers l'excellence, ils offrent des solutions sur mesure qui améliorent la performance tout en garantissant les normes les plus élevées de sécurité et de conformité. Leur équipe expérimentée se consacre à l'amélioration de la santé financière des organisations de santé en optimisant les efforts de recouvrement et en fournissant des expériences supérieures aux clients et aux patients.

Description

• Review potential MVA/TPL accounts and determine whether they meet program and scope requirements • Review registration, diagnosis, accident, insurance, clinical, billing, and account information to validate MVA/TPL status • Investigate accident details, responsible parties, insurance carriers, claim numbers, attorney representation, and reimbursement sources • Communicate with patients, insurance carriers, claims adjusters, attorneys, and other involved parties • Confirm claims have been submitted and perform follow-up, resubmission, and supporting-documentation activities • Prepare and submit claim documentation, including itemized statements, medical records, accident information, and other materials • Identify accounts requiring corrected claims, demographic or insurance updates, coding review, or client-system corrections and route requests • Prepare, submit, document, and track hospital liens • Monitor lien status, notices, documentation requirements, follow-up dates, and settlement activity • Maintain follow-up with liability carriers, attorneys, patients, and other responsible parties regarding claim status and reimbursement • Resolve routine payment, billing, documentation, and claim-processing issues • Escalate disputed, delayed, underpaid, complex, or unusual accounts to a Level II Specialist or leadership • Review payments, adjustments, account balances, demographic changes, and account updates • Maintain complete documentation of investigations, claim activity, communications, lien activity, payments, and final account disposition • Use EHR, payer and carrier resources, client systems, and Revco account-management systems to research assigned accounts • Prioritize daily workload and identify recurring account issues or barriers for leadership • Participate in training and ongoing development related to MVA/TPL claims, hospital liens, and healthcare reimbursement • Perform other duties and special projects as assigned

🎯 Exigences

• 1–3 years of experience in healthcare revenue cycle, medical billing, insurance follow-up, claims administration, MVA/TPL, workers' compensation, bodily injury claims, subrogation, medical liens, or a related environment preferred • Previous hospital or provider-side revenue cycle experience preferred • Familiarity with insurance claims, healthcare billing, payments, adjustments, and reimbursement processes • MVA/TPL or liability claims experience strongly preferred, or relevant healthcare or insurance claims experience • Ability to research account information, identify missing information, and follow established processes through resolution • Ability to communicate professionally with patients, attorneys, claims adjusters, insurance carriers, clients, and internal departments • Strong written and verbal communication skills • Strong organizational and follow-up skills • Demonstrated attention to detail and accurate account documentation • Ability to manage multiple accounts and competing priorities • Experience with EPIC, Cerner, Meditech, CRXIS, or comparable patient accounting/account-management systems preferred but not required • Compliance with HIPAA, regulatory requirements, client requirements, and company policies and procedures

🏖️ Avantages

• Equal employment opportunity commitment • Reasonable accommodations during the application and hiring process for qualified individuals with disabilities and applicants with pregnancy-, childbirth-, or related medical-condition limitations