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Job description
Revenue Cycle/ Follow Up SpecialistHealthcare Legal Solutions, LLC is a fast-growing healthcare collections firm that provides denial management, consulting, and corporate collections services to hospitals and health systems nationwide. Our team is collaborative, mission-driven, and focused on results. This is a great opportunity for candidates who are passionate about healthcare, legal writing, and strategy.We are seeking a detail-oriented, organized, and assertive individual for our Revenue Cycle/ Follow Up Specialist position. The candidate would be responsible for the basic collection of unpaid third-party claims and standard appeals, using various billing applications and third-party payer systems. A successful applicant will communicate with payers to resolve issues and facilitate prompt payment of claims. This position requires follow-up with insurance companies to progress the standard appeals process for claim denials and collect outstanding accounts for which payment has not been received. The candidate will use an understanding of claims and appeals submission requirements for payers to expedite payments and utilize a knowledge of appeals and rejections processes to resolve standard issues or escalate to a more senior staff member. This is a full-time (40 hrs/ week), with preference for candidates in the DC-Maryland-and Virginia area.Specific Duties & ResponsibilitiesUse HLS follow-up systems to identify unpaid claims for collection/appealUse HLS follow-up systems to progress the standard appeal process for denied claimsGathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contractReview and update patient registration information (demographic and insurance) as neededResolves claim edits as neededEscalates any faulty accounts for correction, additional review, or delegation to more senior staff membersPrints and mails appeals and related documents as neededRetrieves supporting documents (medical reports, Explanations of Benefits authorizations, etc.) as needed and submits to third-party payersIdentifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility, and any other issue causing non-payment of claimsContacts the payers or patient as appropriate for corrective action to resolve the issue and receive payment of claimsProfessional & Personal DevelopmentParticipate in on-going educational activities, meetings, and opportunitiesKeep current of industry changes by reading assigned material on work related topicsQualificationsBachelor's Degree (BA/BS) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.Other qualifications: BA/BS with a GPA of 3.0 or higherInterest in healthcare and healthcare lawAbility to use various hospital, billing, and patient information computer systemsFamiliarity with compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI)Able to navigate through various computer systems and applications to find information about insurance claimsAbility to prioritize and multi-taskExcellent written and verbal communication skillsProficiency in Microsoft Office, including Word and ExcelExcellent organizational and time management skillsHigh attention to detailClear, concise, and logical writing styleContinuous performance improvement and ability to implement feedback
Worksite address
washington, DC, 20001, US
Who can apply
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