Revenue Recovery Representatives
7 days ago
Description:
**Duties and Responsibilities**
- Verify members’ benefits, effective dates, claim, and appeal information with insurance companies.
- Research claims and insurance information through New York State’s Eagle and Epic system.
- Review account history and Medical Records in search of potential coverage.
- Review claim denials and contact payers to dispute or request claims to be reprocessed.
- Work on clearinghouse reports and determine proper next steps for the accounts.
- Organize time frames in which claims must be appealed.
- Use Microsoft Outlook to set follow-up reminders.
- Provide daily/weekly updates to management.
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Works specifically with Collection Team on Self Pay/Bad Debt Accounts.
**Requirements**:
- High School Diploma or equivalent
- Must have basic Patient Accounts knowledge or experience.
- Must be comfortable speaking with external contacts, including insurance company representatives.
- Have solid data entry skills and the ability to learn proprietary databases.
- Experience with NAVI-Net, Epic, and various payer portals.
- Strong verbal and written communication skills
- Strong organization and time-management skills and the ability to work in a fast-paced environment.
- Excellent customer service skills
- Solid investigative skills and a persistent demeanor
- Reliable, detail-oriented, resourceful, and analytical
- Must be amenable to work onsite
- Must be amenable to work US hour shifts
**Working Conditions**
- _ Physical Demands: _While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- _ Mental Demands:_ The employee must be able to follow directions, collaborate with others, and handle stress.
- _ Work Environment: _The noise level in the work environment is usually mínimal.
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