Medical AR Denials and Edits Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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CorroHealth

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth is a leading provider of clinically led healthcare analytics and technology-driven solutions, focused on enhancing the financial performance of hospitals and health systems. Their integrated solutions and advanced technologies aim to optimize the entire revenue cycle, offering services such as revenue cycle management, clinical documentation, medical coding, and denials management. With a commitment to improving financial health through intelligent technology and expert guidance, CorroHealth addresses complex payer-provider relationships and supports efficient healthcare operations.

📋 Description

• Ensure timely collections of outstanding government or commercial healthcare insurance receivables • Follow up on outstanding accounts receivable for all payers, including self-pay, and resolve denials • Interact with insurance plans, patients, physicians, attorneys, and team members • Verify or obtain patient eligibility and healthcare service authorizations • Update patient demographics and insurance information in appropriate systems • Research and status unpaid or denied claims • Monitor claims for missing information, authorization, and control numbers (ICN/DCN) • Research EOBs for payments or adjustments to resolve claims • Contact payers by phone or written correspondence to secure claim payments • Access client systems to review payments, open claims, and related data • Follow prioritization, timely filing deadline, and notation protocols • Secure medical documentation requested by third-party insurance carriers • Research provider billing manuals for billing guidelines and requirements • Write appeal letters for technical appeals • Verify underpayments by researching contracts and claims data • Prepare claims for clinical audit processing in cases of authorization, coding, level-of-care, or length-of-stay denials • Report to the Manager, AR Services

🎯 Requirements

• 3+ years of accounts receivable experience within the healthcare revenue cycle • Minimum of 2 years’ experience with Medi-Cal • 2+ years of experience with healthcare and/or insurance billing and processing • Experience with professional physician and hospital facility claims • Ability to read and interpret an EOB • Knowledge and understanding of UB04 and HCFA 1500 forms • High School diploma • Proficiency with Outlook, Excel, and Word, including email, calendar, tasks, and basic formulas • Ability to communicate in a professional and clear manner • Strong interpersonal skills • Ability to work independently • Analytical and critical thinking skills • Ability to perform work at a computer terminal for 6–8 hours a day • Ability to lift and move material weighing up to 20 lbs. infrequently

🏖️ Benefits

• Professional development and personal growth opportunities • Investment in team members’ long-term careers • Remote work arrangement