Claims account specialist job description

Convergent Revenue Cycle Management Inc., a company which specializes in healthcare reimbursement for hospitals all over the United States, is interviewing for a Remote Accounts/Claims Specialist position. The selected candidate will report directly to a Supervisor or Supervising Attorney. Responsibilities include, but are not limited to, working a caseload of 300 to 350 claims, contacting insurance companies to appeal wrongfully denied or underpaid insurance claims, identifying client/payer issues, billing claims and adjusting balances in EPIC, and maintaining a working knowledge of assigned client hospitals and insurers. Full week of paid Virtual Training will be provided. The successful Candidate(s) will then work remotely from a HIPAA compliant home office.

Draft appeals and demands to insurance companies to ensure timely resolution and payment of claims, as well as argue verbally over the phone with insurance companies to get denials overturned and paid

Perform contractual analysis on paid claims to ensure that our client hospitals are reimbursed accurately and according to contract, and to ensure payment integrity
Must work with the client to ensure the mutual success of our respective organizations
Know how and when to involve key players in an account and effectively use internal employer resources to provide the best client solution
Report any reimbursement trends/delays to supervisor
Effectively utilize various means for collections, including but not limited to phone, fax, mail and online methods
Attend meetings and complete post-meeting reports and summaries
Establish regular communication with client regarding outstanding issues and program performance

Education and Experience:

Experience in a healthcare revenue cycle (claims, billing, coding, reimbursement etc.), role is required
Experienced with Microsoft Office including PowerPoint, Excel, and Word
Appeal Writing experience is preferred
EPIC experience with billing and balance adjustment is preferred

Competencies:
Candidate must have excellent oral and written communication skills
Individual must be high energy, creative, customer focused, proactive and action oriented
Must have demonstrated competency in working in teams, and ability to effectively communicate with all levels
Excellent interpersonal, oral and written communication skills
Ability to work independently
Ability to work with various EHR software (example: EPIC, Cerner, Meditech etc.)
Outstanding organizational, analytical and problem-solving skills
Strong attention to detail
Ability to work well under pressure

Why should you consider Convergent RCM:
Paid training
Team-oriented work environment
Growth opportunity
Community Involvement – Convergent RCM loves to give back!
Comprehensive benefits package available: including medical, dental and vision, 401k retirement plan with employer matching, paid time off and paid holidays!




Compensation will be discussed in further detail at the time of the interview.