Team Lead – Prior Auths, Insurance Verification

🔥 4 minutes ago

☕ Washington – Remote

☕ Washington – Remote

💵 $25 / hour

⏰ Full Time

🟠 Senior

🔒 Insurance

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GetixHealth

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

☁️ SaaS

🤝 B2B

💰 Private Equity Round - Getix on 2015-01

SaaS • B2B

GetixHealth is a healthcare revenue cycle management company that provides SaaS-based software suites and dedicated services to hospitals, physician groups, and industry partners. Their solutions cover patient access, eligibility and enrollment, workers’ compensation, insurance resolution, coding and chart audits, self-pay billing, and professional RCM services aimed at improving financial performance, productivity, and patient experience. GetixHealth partners with large healthcare systems and providers to automate and integrate revenue cycle workflows and optimize collections and operations.

📋 Description

• 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.

🎯 Requirements

• 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

🏖️ Benefits

• 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.