Appeals Discrepancy Collector Clerk

hace 3 semanas


San Francisco, Heredia, Costa Rica Auxis A tiempo completo

Job Summary:


You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.

This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.

The Appeal Discrepancy Collector is responsible for researching and resolving Underpayments.

Responsibilities:

  • Perform and validate discrepancy reason coding of underpayment inventory
  • Pursue additional payment from payers on underpayment discrepancies through various means of communication, such as telephonically, online or via payment package processes.
  • Overcome objections that prevent payment of the claim
  • Gain commitment for payment through concise and factual collection techniques.
  • Communicate trends to management as identified
  • Facilitate correction of nonpayment related underpayment discrepancies through Iplan changes or coordination with other departments as needed
  • Identify and communicate trends to management, including those that might be appropriate for the dispute resolution process
  • Escalate accounts to appropriate individuals at the payer and via SSC management as needed, including accounts with lack of timely payer response
  • Utilize effective documentation standards that support a strong historical record of actions taken on the account.
  • Meet the productivity and quality standards of the organization
  • Complete and comprehend all educational requirements
  • Adheres to and supports organizational IT&S standards, policies, and procedures.
  • Adheres to Code of Conduct.
  • Performs other duties as assigned.

Skills and Experience:
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Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
-
Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
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Interpersonal skills - able to work effectively with other employees, patients and external parties
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Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems

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Basic skills:

- demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.

  • English
  • Spanish Language (Oral and writing 85% or higher), (B2+ or above).
  • Must have a high school diploma or in progress to complete high school.
  • At least 6 months of experience in Customer Service positions.
  • This job adjusts to the Eastern Time Zone and follows a US holiday schedule.
  • Strong customer service skills
  • Excellent communication skills
  • Ability to work independently and collaboratively
  • Attention to detail
  • Comfortable multitasking in a high volume/high demand environment
  • Good presentation and a polite, tactful, and friendly character.

About Auxis:
Auxis prioritizes employee growth and development to help you advance your career. Auxis' culture empowers you to be your best in the interest of a common team goal.

We are constantly striving to improve our culture and environment and have invested in tools to continue to have better visualization of the pulse of our organization.


  • Benefits_
  • Health benefits including medical, vision, and dental.
  • Transportation subsidy
  • Asociacion Solidarista
  • Training and development programs
  • Employee recognition program
  • Paid time off and familypaid leave
  • Paid day off for your birthday


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