Revenue Claim Reviewer I
Home Care Delivered, Inc. was founded by Gordy Fox in 1996 as a result of his own personal experience with family members aging and living with chronic medical conditions. He found that it wasn’t easy for people in the home health setting to get the information or the supplies they needed to care for themselves or to follow their physician’s treatment plans properly. HCD provides only the highest quality medical supplies and products. We carry thousands of items from leading providers in the industry and deliver them within 48 hours to your door.
JOB SUMMARY
Ensures that Home Care Delivered, Inc. is properly reimbursed on claims it has submitted for payment. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and polices.
• * This role is 100% remote but EST is preferable.**
ESSENTIAL DUTIES
• Researches and resolves issues with claims, including denials and appears for assigned payer group.
• Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.
• Effectively communicates with other revenue management staff and management, including potential changes to PayerPro, changes in fee schedule, need for prior authorization, etc.
• Maintains appropriate level of communication and confidentiality.
• Performs all other duties assigned, which may vary at any time with our without notice.
COMPETENCIES
• Able to complete tasks in specified time frame.
• Demonstrates strong organization skills and proven ability to multi-task and manage time in order to meet frequently changing deadlines in a fast-paced environment.
• Demonstrates superior professional ethics and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete security.
• Demonstrates excellent interpersonal, oral, and written communication skills.
• Demonstrates excellent organizational skills as well as strong attention to detail.
• Demonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workload.
• Must demonstrate experience in Microsoft office and proficiency in claim management systems.
EDUCATION/EXPERIENCE
• High School Diploma and/or GED required. Associates Degree, strongly preferred. Degree can be in general studies, accounting, finance or similar course of study.
• Experience with insurance billing and/or collections required.
Apply Now
JOB SUMMARY
Ensures that Home Care Delivered, Inc. is properly reimbursed on claims it has submitted for payment. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and polices.
• * This role is 100% remote but EST is preferable.**
ESSENTIAL DUTIES
• Researches and resolves issues with claims, including denials and appears for assigned payer group.
• Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.
• Effectively communicates with other revenue management staff and management, including potential changes to PayerPro, changes in fee schedule, need for prior authorization, etc.
• Maintains appropriate level of communication and confidentiality.
• Performs all other duties assigned, which may vary at any time with our without notice.
COMPETENCIES
• Able to complete tasks in specified time frame.
• Demonstrates strong organization skills and proven ability to multi-task and manage time in order to meet frequently changing deadlines in a fast-paced environment.
• Demonstrates superior professional ethics and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete security.
• Demonstrates excellent interpersonal, oral, and written communication skills.
• Demonstrates excellent organizational skills as well as strong attention to detail.
• Demonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workload.
• Must demonstrate experience in Microsoft office and proficiency in claim management systems.
EDUCATION/EXPERIENCE
• High School Diploma and/or GED required. Associates Degree, strongly preferred. Degree can be in general studies, accounting, finance or similar course of study.
• Experience with insurance billing and/or collections required.
Apply Now