Medical Claims Follow-Up Specialist

RSource; Alabama; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented Medical Claims Follow-Up Specialist to join their Revenue Recovery team. This remote position offers the flexibility to work from home while advocating for patients and resolving outstanding hospital bills. You will utilize your analytical skills to navigate complex claims, ensuring timely follow-ups and compliance with all regulations. With a commitment to professional growth, this role provides opportunities for advancement within a supportive environment. If you're passionate about making a difference in healthcare and enjoy working in a fast-paced setting, this is the perfect opportunity for you.

Benefits

Full Benefits

100% Remote Work

Growth Opportunities

Comprehensive health plans

Dental insurance

Vision insurance

Life insurance

Short term disability

Long term disability

Generous PTO policy

Qualifications

• High level of professionalism and adherence to HIPAA requirements.
• Moderate computer proficiency with MS Office tools.
• Familiarity with CPT and ICD coding preferred.

Responsibilities

• Follow up on patient bills using the Artiva system to recover revenue.
• Analyze denied claims to determine next steps.
• Ensure timely filing guidelines are met for maximum reimbursement.

Skills

Professionalism

Adherence to debt collection rules

HIPAA compliance

Computer proficiency

Organization skills

Mathematical ability

CPT and ICD coding knowledge

Tools

Artiva workflow management system

MS Excel

MS Word

MS Outlook

Job description

A Medical Claims Follow-Up Specialist, known at Knowtion Health as a Specialist I, Revenue Recovery, effectively and consistently generates revenue through professional billing practices, using proper and ethical collection efforts. Knowtion Health works as an ambassador on behalf of patients to resolve outstanding hospital bills and never collects monies from patients. In addition to drafting appeals, Specialists must demonstrate proficient use of web-based client and payer portals along with notation databases. This position is remote.

Join us at Knowtion Health as a member of our Revenue Recovery team!

What We Offer:

• 100% Remote Work: Embrace flexibility and say goodbye to commutes.
• Full Benefits: Comprehensive health, dental, and wellness plans because your wellbeing is important.
• Growth Opportunities: Knowtion Health is a continuously growing 3rd party Hospital Revenue Cycle Management company providing promotion opportunities for those both interested and qualified.

Who We Need:

• Someone with:
• A high level of professionalism
• Adherence to all debt collection rules and regulations
• Adherence to HIPAA requirements
• Moderate computer proficiency including working knowledge of MS Excel, Word, and Outlook
• Organization and documentation skills to ensure timely follow-up and accurate record keeping
• Mathematical ability to calculate rates using addition, subtraction, multiplication, and division
• Familiarity with CPT, ICD coding preferred

Your Role Will Involve:

• Using the Artiva workflow management system, follow up on patient bills and claims to recover revenue from the responsible business entity. Depending on the department, the business entities may include any or all the following: commercial health insurance, governmental insurance, veteran’s benefits, third party administrators, attorneys, motor vehicle carriers, employers and worker’s compensation carriers.
• Analyze information to identify root cause of denied or unpaid claim and determine next steps.
• Pursue & obtain information needed to overturn claim denials, including patient & responsible party information, medical necessity, employer information, accident information.
• Ensure appropriate timely filing guidelines are met for maximum reimbursement.
• Escalate complex, complicated, or challenging accounts to management to ensure accounts are progressing effectively.
• Identify and discuss root cause issues with management.

Compensation:

• The pay range for this position starts at $17/hr and increases depending on experience and qualifications.

Are You Ready? If you have a knack for details, a passion for patient advocacy, and a desire to make a significant impact in a fun and fast-paced environment, we would love to meet you!

The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.

This position is remote and requires a dedicated, distraction-free work space at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, paid holidays, 401k, and a generous PTO policy.