Denials Follow Up Rep

CorroHealth•FL-Remote, FL

2d•Remote

About The Position

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. We offer the following products and services: Denials Management and Complex Claim Resolution, A/R Outsourcing, Patient Access, Revenue Cycle Technology, and Consulting.

Requirements

At least 2 years' experience differentiating between clinical and technical denials through EOB’S, denial letters/payer correspondence and data mining
Knowledgeable and have worked with UB04 and/or HCFA 1500 Forms
Comfortable contacting payers to negotiate resolution on denials
Understanding of DRG downgrades
High School Diploma, Four-year degree preferred or equivalent experience in hospital related billing/follow-up field
2 years of experience in hospital related billing/follow-up field.
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

Responsibilities

Differentiates between clinical and technical denials through EOB’S, denial letters/payer correspondence and data mining.
Knowledgeable in reviewing UB04 and/or HCFA 1500 Form
Reviews timely filing guidelines regarding the appeals process.
Contacts payer 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.