Finance - Revenue Cycle

Remote 200 • Weatherford, TX

13d • $18 - $20 • Remote

About The Position

Pride Health is seeking a Denial Prevention Specialist for one of its clients in Texas. This is a 6-month contract with the possibility of an extension with competitive pay and benefits. This is a work-from-home (WFH) opportunity. The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. Additional details regarding WFH will be discussed as part of the interview process.
Location – Remote (Weatherford, TX 76086)
Pay range - $18 to $20 per Hour on a W2.
Length of assignment – 6 Months of Contract (Possibility of Extension)Shift – Monday to Friday, Flex Start time 6a-9a. 8-hour shift.
Job Summary
The successful candidate will review, research, and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have, but not be limited to, the following skills:
Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed.
Contacting insurance carriers to check on the status of claims, appeals, and insurance verification.
Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid
Preparing/Submitting appeals related to denied services

Requirements

• High School Diploma or GED.
• 2 years of experience in medical claims recovery and/or collections required.
• Work requires a self-starter with the ability to work well as part of a team and independently.
• Work requires the ability to communicate effectively with patients, insurance companies, clinical staff, and management.
• Work requires the ability to handle large volumes of work.
• Work requires the ability to work in a fast-paced, production-oriented environment.
• Work requires excellent customer service skills.
• Work requires experience in Medical Billing

Nice To Haves

• Associate's Degree preferred.

Responsibilities

• Analyze payer denials by denial groupers and submit appeals.
• Contact patients and/or third-party payers to resolve outstanding insurance balances and underpaid claims.
• Make necessary adjustments as required by plan reimbursement.
• Functions as a liaison between clinical departments and the MSRDP management team.
• Completes special projects as assigned.
• Performs other duties as assigned.

Benefits

• Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees