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Company is a health care consulting company, specializing in identifying and collecting managed care underpayments and denials for our customers. Due to rapid growth, they are seeking to add energetic, passionate people to their
Managed Care Professionals.
.Managing team of Claim Analysts throughout multiple client locations in Georgia
.Assigning and distributing work to analyst team members
.Act as a liaison between clients, analysts and Management
.Support and educate Analysts on contracts as needed
.Assist team members with difficult issues concerning their work
.Review and audit the quality and accuracy of staff's work including monthly reports
.Assist in the development of staff members by acting as an instructor and mentor
.Audit claims and search for underpayments
.Review refund requests and denials
.Review managed care contracts and compare against claims to identify underpayments
.Call payors to resolve underpayments found
.Write adjustment and appeal letters to payors to resolve underpayments
.Communicate with client contacts
Job Requirements :
.Minimum of three to five years experience in an operational setting,preferably in managed care or hospital patient accounting department
.Minimum of two years supervisory or management experience
.Analytical and problem solving skills necessary to investigate various issues with carriers and their contracts
.Interpersonal skills, professional conduct and communication skills to effectively gather information, ask questions and discuss problems with internal personnel and clients
.Leadership abilities in order to give constructive feedback, coach, and listen to staff members;
.Experience working with ICD-9, CPT-4 and/or HCPCS coding systems
.Knowledge of insurance submittal procedures and medical forms (including UB04 and CMS1500)
Must Haves:
1. 3+ years experience in an operational setting, preferably in managed care or hospital patient accounting department.
2. 2+ years supervisory or management experience.
3. Experience working with ICD-9, CPT-4 and/or HCPCS coding systems.
4. Knowledge of insurance submittal procedures and medical forms (including UB04 and CMS1500)
5. Local to Louisville KY (possible if from the area and desire to move back).
Warning: Avoid fraudulent jobs and phishing scams, some work from home jobs and any job that asks you to pay to apply! More Info
