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Collections Appeal Advocate (Health Insurance Underpayments) - Remote, US
Job ID R23876
Date posted 04/28/2022
Collections Appeal Advocate (Health Insurance Underpayments)
Overview of Position
Validation and pursuit of underpaid accounts via web portals, payer packages, and phone collections. Submission of written disputes/appeals of underpaid accounts, as well as coordination with clinical staff for medical denial disputes/appeals. Balancing appropriate collections follow up with new incoming inventory validation/pursuit, as well as providing appropriate documentation and progressive action stepping for account resolutions and revenue generation.
What will be my duties and responsibilities in this job?
Research and review facility systems/remits to determine clients' actions/due diligence taken on underpaid/denial claims, as well as payers' processing responses and outcomes.
Actively validate, pursue and collect on denials and underpaid accounts utilizing web portals, payer packages, and phone collections.
Accurately write and submit hospital claim underpayment and denial disputes to insurance companies.
Provide proper and accurate documentation and action updates into various systems.
Monitor inventory volumes and provide timely account follow-up.
Prioritize workloads using use tools and resources in the most efficient manner to produce the highest levels of Revenue.
What are the requirements needed for this position?
2 years' experience with insurance company collections, preferably with hospital claims.
High school diploma or GED required.
Strong decision making and problem-solving skills are needed, coupled with an ability to work independently with minimal supervision.
Knowledge of CPT-4/HCPC/DRG/ICD/HCPCs, and Revenue codes, and familiarity with HIPAA privacy guidelines.
Ability to multitask and set priorities on multiple projects for the highest rate of returns.
What are the working conditions and physical requirements of this job?
Remote office. General office demands
Heavy phone work. Most of your day will be spent on the phone.
How much should I expect to travel?
Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
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COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
Equal Opportunity/Affirmative Action Statement
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Talent Acquisition Process
Once you apply for a job opening, the Sourcing Specialist or Talent Advisor will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.
Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.
If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.
Once you've electronically signed your offer, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.
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