Job Category:
Healthcare, Billing
Pay: TBD
Overview
Primarily responsible for thorough review of managed care contracts and comparison of such contracts against Medicaid claims to identify underpayments for the assigned client.
Duties and Responsibilities
- Build strong, lasting relationships with clients, payors and BLS personnel
- Review insurance contracts to gain thorough understanding of payment methodologies
- Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
- Contact insurance company to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client
- Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting
- Maintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other BLS personnel
- Direct claims to and coordinate and support BLS specialty units
- Attend client, department and company meetings
- Comply with federal and state laws, company policies and procedures
Skills and Experience
- Minimum 3-years Medicaid experience working with claims and/or billing
- Accounts receivable/follow-up experience
- Moderate computer proficiency including working knowledge of Microsoft Word and Excel
- High school diploma or equivalent
- Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division
- Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form
- Ability to write routine correspondence (in English)
- Ability to define problems, collect data, establish facts and draw valid conclusions
- Strong customer service orientation
- Excellent interpersonal and communication skills
- Strong team player
- Commitment to company values
- Associate or Bachelor’s Degree preferred but not required
Company – Revecore
Website – http://www.bls.revecore.com/