Job description
REMOTE OPPORTUNITIES AVAILABLE!
POSITION PURPOSE
This position is responsible for managing the maximization of reimbursement by identifying contractual variances between posted and expected reimbursement for managed care, government contracts, and other various payors. This responsibility encompasses contractual reimbursement analysis and communication of payment discrepancies to internal and external departments.
ESSENTIAL JOB FUNCTIONS:
- Identifying trends in denials
- Research and identify payment discrepancies from various sources
- Compile and analyze data to make recommendations
- Review contract validation, updates, and interpretation
- Resolve unpaid claims in an effective and timely fashion
- Other duties as assigned
EDUCATION:
- High school or equivalent
EXPERIENCE:
- Minimum of 2 years of hospital revenue cycle experience, particularly working with claim denials and writing appeals
- Knowledge of CPT, HCPCS, DRG and revenue codes
- Must possess intermediate to advanced computer skills
- Must have an understanding of medical terminology
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