Credit Resolution Escalation Specialist

🕒 il y a 2 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

🚫👨‍🎓 Aucun diplôme requis

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Ventra Health

Ventra Health

1001 - 5000 employés

Fondée en 2021

🏥 Santé

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Ventra Health est une entreprise de gestion du cycle des revenus de la santé (RCM) qui propose des services complets de facturation médicale, de codage, de gestion des réclamations, de prévention des refus, de contractualisation avec les payeurs et de recouvrement pour les hôpitaux, les systèmes de santé et les cabinets de médecins aux États-Unis. Ses offres combinent expertise du domaine et service client haut de gamme avec des plateformes propriétaires alimentées par des données et l'intelligence artificielle—vCision (IA & automatisation) et vSight (données & analyses)—pour améliorer le remboursement, réduire les refus, accélérer le recouvrement des créances et offrir des améliorations mesurables des performances RCM. Ventra met l'accent sur la prestation de services d'entreprise, la formation des prestataires, les audits de conformité et de codage, la gestion de la responsabilité des patients et la stratégie des payeurs, desservant des milliers de fournisseurs et d'installations à l'échelle nationale.

Description

• Monitor and resolve credit balances and refunds from billing system overages escalated from the Credit team. • Develop a plan to complete daily work lists by the end of each day. • Review refund request letters and determine appropriate resolutions based on contracts and timely guidelines. • Identify trends and notify appropriate departments. • Send check registers to Client Success or Finance for approval. • Obtain check numbers from clients and upload them into the system so credits can be cleared. • Research and correct returned refund checks. • Analyze data from various reports and make recommendations. • Perform special projects and other assigned duties. • Comply with applicable billing laws and provide service to providers nationwide in a team-oriented environment.

🎯 Exigences

• High School Diploma or Equivalent. • Two (2) year of experience posting insurance payments in a healthcare setting. • Two (2) years of experience reading insurance Explanation of Benefits (EOB) statements preferred. • Knowledge of Explanation of Benefits (EOB) statements. • Knowledge of a variety of insurance plans. • Strong oral, written, and interpersonal communication skills. • Strong word processing, spreadsheet, and database software skills. • Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimal. • Strong time management skills. • Strong organizational skills. • Ability to read, understand, and apply state/federal laws, regulations, and policies. • Ability to take initiative and effectively troubleshoot while focusing on innovative solutions. • Ability to remain flexible and work within a collaborative and fast paced environment. • Ability to communicate with diverse personalities in a tactful, mature, and professional manner.

🏖️ Avantages

• Performance-based incentive plan • Discretionary incentive bonus • Referral bonus • Reasonable accommodations for qualified individuals with disabilities

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