Key Accounts Healthcare Claims Specialist
hace 4 semanas
Auxis is a fast-growing business process outsourcing provider supporting one of its largest accounts, a leading healthcare services provider serving 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.
As an appeals underpayment collector, you will ensure timely reimbursement to the provider by monitoring the claims process and keeping medical expenses fair to patients. This role involves
Main Responsibilities:
Triage incoming inventory for the Appeals team to validate appeal criteria
- Compose technical denial arguments for reconsideration, including written and telephonic communication
- Identify contract protection that can be leveraged to overturn denials
- Overcome objections preventing payment and gain commitment through concise appeal arguments
- Identify problem accounts/processes/trends and escalate as necessary
- Utilize effective documentation standards for a strong historical record
- Perform basic math for accurate account statements
- Meet productivity and quality standards
- Complete educational requirements in a timely manner
- Adhere to Code of Conduct philosophy and Mission and Value Statement
- Other duties assigned
Requirements:
- English-Spanish language proficiency (oral and written) at C1 level or above
- High school diploma completed
- At least 6 months of customer service experience
- Strong customer service skills
- Excellent communication skills
- Ability to work independently and collaboratively
- Attention to detail
- Comfortable multitasking in high volume/high demand environments
- Good presentation and polite character
Benefits:
- Health benefits including medical, vision, and dental coverage
- Transportation subsidy
- Training and development programs
- Employee recognition program
- Paid time off and family-paid leave
- Birthday paid day off
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