HighFive Healthcare
501 - 1000 employees
You’re already on top of your game; we’re just helping you raise the bar.
Part-time Accounts Receivable Specialist
🔥 0 minutes ago
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HighFive Healthcare
501 - 1000 employees
You’re already on top of your game; we’re just helping you raise the bar.
📋 Description
• Investigate, appeal, and resolve denied or rejected claims by insurance payors. • Work with insurance companies to clarify discrepancies and ensure proper reimbursement. • Review and assess Explanation of Benefits (EOBs) at the claim level to determine issues. • Determine root cause of any billing related or claim submission issues to prevent recurrence. • Make corrections to claims based on denials and rebill utilizing standardized process and procedures. • Follow up with unresolved claims through system resources, clearinghouse, payer portal or call to the payor, when necessary. • Assess whether an appeal is required for a claim denial. • Track appeals to ensure timely payment and resolution. • Spot recurring patterns in denials and report them to management for further analysis and action. • Effectively communicate both verbally and in writing with team members, payors, patients, and other relevant parties. • Keep up to date with internal processes, industry standards, and government regulations relevant to denial management to ensure compliance and best practices.
🎯 Requirements
• Oral Surgery billing experience required. • High school diploma or equivalent; associate or bachelor’s degree in healthcare, business, or a related field preferred. • Minimum of 2 years of experience in healthcare billing and accounts receivable. • Knowledge of medical insurance plans, billing procedures, and healthcare reimbursement processes. • Proficiency with Electronic Health Record (EHR) systems and billing software. • Working knowledge of excel and system workflows. • Strong attention to detail with the ability to accurately review and process claims. • Excellent communication and problem-solving skills. • Ability to work independently and manage multiple tasks simultaneously. • Knowledge of HIPAA and other healthcare compliance regulations.
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