Healthcare Reimbursement Specialist

hace 2 semanas


San Francisco, Heredia, Costa Rica Experian A tiempo completo

About Us: At Experian, our mission is to simplify healthcare for all by leveraging data-driven insights. We strive to create a diverse and inclusive work environment where collaboration, innovation, and accountability thrive.

Job Summary: As a Healthcare Reimbursement Specialist, you will play a critical role in monitoring contractual allowances, analyzing appeal opportunities, and reporting performance metrics.

Key Responsibilities:

  • Implement processes for identifying under-allowed claims using software and other available tools.
  • Analyze EOBs for identified under-allowed claims, verifying applicable contracts and member information.
  • Refine communication skills and tools for preparing written and telephone appeals.
  • Compile and submit appeals, monitoring for proper reimbursement.
  • Establish and maintain helpful contacts in payer or network offices.
  • Prepare monthly performance statistics regarding appeals and recoveries.
  • Monitor and track contractual, billing, registration, and posting errors, providing continuous feedback.

Requirements:

  • High School completed with some university studies preferred.
  • Minimum one to two years experience working with managed care claims and appeals.
  • Experience in a production environment desirable but comfort in such an environment essential.

Compensation: The estimated annual salary for this position is $62,000-$80,000, depending on location and experience. Please note that this figure is based on industry standards and may vary depending on various factors.



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