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Sr. Revenue Cycle Specialist

2 months ago

Denver, United States Tranzeal Incorporated Full time

Job Title: Sr. Revenue Cycle Specialist: Medicaid Collections

Location: Denver, CO / Remote

Duration: 4+ months


Please Note:

The team is looking to steer clear of billing and coding experience


ESSENTIAL DUTIES AND RESPONSIBILITIES:

Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid Medicaid and managed plan insurance claims

Research, appeal, and address claim rejections, underpayments, and denials according to policy and procedure (including but not limited to rebilling, correcting coding, calling the payer or clinic, and utilizing payor portals)

Resolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, and Medicare/Medicaid eligibility

Identify and rectify billing issues related to updates outlined in Medicaid provider manuals and provider bulletins

Address patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursement

Navigate through various payer systems, provider portals, and internal applications to ensure timely and accurate claim resolution

Demonstrate ability to build strategic business relationships with internal and external partners (i.e., the Billing & Coding Team, Registration Department, Medicare Collections Team, Credit Department, and the payer(s))

Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims

Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and policies


Schedule:

8 hour shift; regular business hours

Monday -Friday


Qualifications:

Proficiency in Microsoft Office tools including Excel, Word, and Outlook (required)

Experience working with Medicaid and Medicare payers (required)

Healthcare revenue cycle, medical billing, and collections experience (3-5 years+) preferred


Education:

High School Diploma or equivalent (required); Associates or Bachelor's degree (preferred)