About The Position

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: Job Summary: CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs. We work with 300+ providers in 25+ states and bring a client-focused approach that makes each provider feel like our only client. CorroHealth offers the following products and services: Denials Management and Complex Claim Resolution, A/R Outsourcing, Patient Access, Revenue Cycle Technology, and Consulting. ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Requirements

  • Four-year degree preferred or equivalent experience in hospital related billing/follow-up field
  • Benefits/fund administration experience preferred.
  • Knowledge of/experience working with managed care contracts.
  • Experience working with customer support/client issue resolution management.
  • Strong analytical acumen.
  • Strong multi-tasking skills.
  • Proficiency with MS Office.
  • Excellent oral and written communication skills.

Responsibilities

  • Differentiates between clinical and technical denials through EOB'S, denial letters/payer correspondence and data mining.
  • Identifies payer and hospital’s managed care contracts.
  • Reviews managed care contracts against application of rates, provisions and terms.
  • Reviews timely filing guidelines regarding the appeals process.
  • Contacts payers to negotiate resolution on technical denials.
  • Appeals denials using all means necessary (appeal letters, medical records and other supporting documentation, utilization of on-staff clinicians).
  • Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal).
  • Manages assigned workload of accounts through timely follow up and accurate record keeping.
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