![HarmonyCares](https://media.trabajo.org/img/noimg.jpg)
Denial Management Specialist Lead
4 weeks ago
OverviewHarmonyCares is one of the nation’s largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.Our Shared Vision – Every patient deserves access to quality healthcare.Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.Why You Should Want to Work with UsHealth, Dental, Vision, Disability & Life Insurance, and much more401K Retirement Plan (with company match)Tuition, Professional License and Certification ReimbursementPaid Time Off, Holidays and Volunteer TimePaid Orientation and TrainingGreat Place to Work CertifiedEstablished in 11 statesLargest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today ResponsibilitiesThe Denial Management Specialist Lead, CNC & Specialty Programs is responsible for the optimal payment of claims for Centene and Wellcare Payers, along with any other payers within the Health Risk Assessment and Value Based Care programs. Primary duties include but are not limited to: Consistently following up on unpaid, underpaid & denied claims utilizing weekly aging reports, biweekly A/R report distribution to staff, value-based encounter denial follow up, filing appeals when appropriate to obtain maximum reimbursement, establish and maintain strong relationships with payers, monitor trends in denials and payment changes. Works closely with department manager to communicate claims issues to Specialty Programs Operations Team, Centene and Health Risk Assessment Teams. This position will be responsible for leading the team to resolve problems, as well as working with other departments on reimbursement challenges. (This person will need to live in or near Troy, MI and go into the office; specifically on Thursdays- once a week for collaboration meetings).Essential Duties & ResponsibilitiesAssist in facilitating training and onboarding experience for new hiresAssist in creation/maintenance of Standard Operating ProceduresResponsible for cross-training current team members or specialized training for projectsPoint of contact for issue resolution with the departmentCollaborate with other Revenue Cycle Management departments or Operational teams to resolve issuesAssist in Compiling Productivity and Quality MeasuresReview Claims failed on Front End Edits due to various reasons; analyze the root causeReview and analyze insurance claims/encounters both in aged and denied AR for HarmonyCares Value Based and Centene plansAccess denied claims from the worklist and query claim status with the payor, utilizing all appropriate systems & websites to effectively research the claim and resubmit or appeal as necessaryResolve for root cause denial reasons, reduce denial trending and communicate trends to managementAssist the team in prioritizing claims based on aging and outstanding dollar amounts, or as directed by managementLearn and understand internal/external operating systems to help staff navigate obstacles, including but not limited to: Centricity, EDI, Waystar, Various Insurance portalsRegularly meet with supervisor to discuss challenges or billing obstacles as well as to provide status of outstanding aging reportsAssist Management in submission and monitoring of Invoices to various plans through various processesOther duties as assigned QualificationsRequired Knowledge, Skills and ExperienceHigh School diploma or equivalent5+ years of insurance follow up experience in a healthcare insurance environment and ability to multitaskComputer experience is essential, including but not limited to: Microsoft products, with a heavy focus on Excel, Work, PowerPoint, and SharePoint Ability to use critical thinking skills for troubleshooting staff questions/issuesKnowledge of multi-specialty physician billing procedure guidelines according to Medicare, Medicaid, Commercial, and third-party payer policies and basic understanding of medical terminology, ICD and CPT codesKnowledge of value-based care modelExperience in filing claim appeals with different payers to ensure maximum entitled reimbursementAbility to perform mathematical computationsSkill in defining problems, collecting data and interpreting billing informationAdditionally, the ability to work effectively with staff, patients, public and external agenciesGood customer service and telephone techniques required as well as a high level of confidentiality Preferred Knowledge, Skills and ExperienceAssociates degreeCertification in Medical Billing/CodingCertified Revenue Cycle Representative (CRCR) Posted Min Pay Rate USD $25.68/Yr. Posted Max Pay Rate USD $31.18/Yr. Pay TransparencyIndividual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations. NoticeHarmonyCares and HarmonyCares Hospice are not affiliated with Harmony Hospice Care. HarmonyCares Hospice does not conduct business in OH. HarmonyCares Hospice conducts business in MI, VA, WI, TX, IN, IL.
-
Lead Specialist in Claims Management
1 week ago
Independence, Kansas, United States HarmonyCares Full timeOverviewHarmonyCares stands as one of the leading home-based primary care providers in the nation. Our organization encompasses a family of companies committed to delivering high-quality, coordinated healthcare directly to patients' homes. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health, and HarmonyCares Hospice.Our Mission...
-
Lead Specialist in Claims Management
1 week ago
Independence, Kansas, United States HarmonyCares Full timeOverviewHarmonyCares stands as one of the largest home-based primary care organizations in the nation. We are a collective of companies dedicated to delivering high-quality, coordinated healthcare services in the comfort of patients' homes. Our family includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health, and HarmonyCares Hospice.Our...
-
Lead Specialist in Claims Management
1 week ago
Independence, Kansas, United States HarmonyCares Full timeOverviewHarmonyCares stands as one of the leading home-based primary care providers in the nation. Our family of companies is committed to delivering high-quality, coordinated healthcare directly in the home. This encompasses HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health, and HarmonyCares Hospice.Our Mission – To provide personalized,...
-
Healthcare Billing Specialist
1 week ago
Independence, Missouri, United States Caudill Dermatology Full timeCaudill DermatologyAt Caudill Dermatology, we are dedicated to providing exceptional dermatological care while fostering a positive work environment.Position OverviewThis full-time, on-site position for a Healthcare Billing Specialist involves managing medical billing processes, addressing claim denials, utilizing ICD-10 coding, collaborating with insurance...
-
Lead Echocardiography Specialist
1 week ago
Independence, Missouri, United States Centerpoint Medical Center Full timeOverviewAre you seeking a fulfilling role as a Lead Echocardiography Specialist? Join Centerpoint Medical Center, a prominent member of HCA Healthcare, the leading provider of healthcare services in the nation.BenefitsAt Centerpoint Medical Center, we offer a comprehensive rewards package designed to support the health, life, career, and retirement of our...
-
Correspondence Specialist
2 weeks ago
Independence, United States Cleveland Clinic Full timeJoin the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of...
-
Sales Manager
2 days ago
Independence, United States Management Recruiters International Full timeWe are working with a leading provider of inverters and power conversion technology used in wind, solar, and electric vehicle charging. To date, they have delivered 28 GW globally, through Solar PV inverters and Energy Storage. Their US HQ will be ramping production for domestic content requirements. To support their growth, we have been retained to find an...
-
Sales Manager
1 week ago
Independence, United States Management Recruiters International Full timeWe are working with a leading provider of inverters and power conversion technology used in wind, solar, and electric vehicle charging. To date, they have delivered 28 GW globally, through Solar PV inverters and Energy Storage. Their US HQ will be ramping production for domestic content requirements. To support their growth, we have been retained to find an...
-
Patient Access Specialist I
1 month ago
Independence, United States University Hospitals Full timePatient Access Specialist I - UH Geauga - (2400081V) UH Geauga Medical Center Monday through Friday start times between 5:30am and 8:30am, rotating weekends second shift 3:30pm - 12:00am Holidays required A Brief Overview As an essential member of the Revenue Cycle team, Access Specialists perform accurate registration, patient estimates, point of...
-
Technical Sales Specialist
1 week ago
Independence, Kansas, United States Management Recruiters International Full timeAbout the Company:Management Recruiters International is a premier executive search firm specializing in the solar, renewable energy, and energy storage sectors. Our team of recruiting experts is well-connected within the industry, collaborating with some of the most reputable and rapidly expanding companies in renewable energy. We have successfully placed...
-
Operations Specialist
2 weeks ago
Independence, United States MAI Wealth Management, Inc. Full time $43,000 - $54,000Job DescriptionJob DescriptionGENERAL JOB DESCRIPTIONThe Operations Specialist is responsible for processing a variety of daily operational requests such as account onboarding, maintenance, transaction entry, billing, quarterly reporting, and other client and advisor requests. This role provides support to ensure the Investment Operations team efficiently...
-
Operations Specialist
1 month ago
Independence, United States MAI Wealth Management, Inc. Full timeJob DescriptionJob DescriptionGENERAL JOB DESCRIPTIONThe Operations Specialist is responsible for processing a variety of daily operational requests such as account onboarding, maintenance, transaction entry, billing, quarterly reporting, and other client and advisor requests. This role provides support to ensure the Investment Operations team efficiently...
-
Senior Operations Specialist
1 month ago
Independence, United States MAI Wealth Management, Inc. Full timeJob DescriptionJob DescriptionGENERAL JOB DESCRIPTIONThe Senior Investment Operations Specialist is responsible for trade settlements and trade reconciliations, the quarterly reporting process, account billing process, contributions and client requests. This role provides both strategic and tactical perspectives to ensure the Investment Operations team...
-
Senior Operations Specialist
2 weeks ago
Independence, United States MAI Wealth Management, Inc. Full time $51,000 - $63,000Job DescriptionJob DescriptionGENERAL JOB DESCRIPTIONThe Senior Investment Operations Specialist is responsible for trade settlements and trade reconciliations, the quarterly reporting process, account billing process, contributions and client requests. This role provides both strategic and tactical perspectives to ensure the Investment Operations team...
-
Environmental Waste Management Specialist
1 week ago
Independence, Missouri, United States Clean Harbors Full timeJob Overview**Class B (CDL) License Sponsorship Available**Clean Harbors is in search of an Environmental Waste Management Specialist to oversee the handling, segregation, packaging, and inspection of chemical waste in compliance with Federal, State, and Local regulations, as well as our internal policies and procedures. This role requires working in various...
-
Healthcare Billing Coordinator
1 week ago
Independence, Missouri, United States Caudill Dermatology Full timeAbout Caudill DermatologyAt Caudill Dermatology, we are dedicated to providing exceptional dermatological care while fostering a positive work environment.Position OverviewWe are seeking a full-time Medical Biller to join our team. The Medical Biller will play a crucial role in managing medical billing processes, addressing claim denials, utilizing ICD-10...
-
Medical Biller
1 month ago
Independence, United States Caudill Dermatology Full timeCaudill DermatologyWe practice the best dermatology and have the most fun doing it. Role DescriptionThis is a full-time on-site role for a Medical Biller at Caudill Dermatology in Clarkston, MI. The Medical Biller will be responsible for handling medical billing, processing denials, using ICD-10 coding, working with insurance companies, and understanding...
-
Retail Sales Specialist
1 week ago
Independence, Missouri, United States Recovery Management Corporation Full timeAbout Recovery Management CorporationRecovery Management Corporation is a leading entity in the field of asset recovery and inventory management. We pride ourselves on our extensive range of products and opportunities for career progression. Our workplace culture is characterized by positivity and collaboration.Compensation:$17.50/hr. to $20/hr.,...
-
Sales Floor Specialists
1 week ago
Independence, Missouri, United States Recovery Management Corporation Full timeAbout Recovery Management CorporationWe are a leading organization dedicated to managing and monetizing surplus inventory for various esteemed U.S. businesses. Our operations encompass a wide range of consumer goods and commercial products, ensuring a diverse and exciting work environment.Compensation:$15.00/hourWork Schedule:Evenings & weekendsDepartments...
-
Retail Sales Specialist
1 week ago
Independence, Missouri, United States Recovery Management Corporation Full timeRecovery Management Corporation is a vibrant and expanding organization. We offer an unparalleled selection of products and opportunities for career growth. Our welcoming and supportive environment is truly exceptional. Compensation Range: $17.50/hr. to $20/hr., depending on qualifications Your Responsibilities: Visual Merchandising: Design engaging displays...