Key Accounts Healthcare Claims Specialist
hace 13 horas
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
-
Healthcare Claims Support Specialist
hace 1 mes
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob Title: Healthcare Claims Support AnalystAt Experian Health, we're shaping the future of U.S. healthcare with innovative solutions. As a Healthcare Claims Support Analyst, you'll play a crucial role in ensuring seamless claims and remit processes for our clients.Key Responsibilities:Monitor claims and remit activity using in-house applications,...
-
Healthcare Specialist
hace 13 horas
San Francisco, Heredia, Costa Rica Auxis A tiempo completoAuxis is seeking a highly skilled Healthcare Specialist to join our team in resolving pre-bill insurance claims.Job SummaryThis role involves reviewing pre-bill accounts for discrepancies, communicating with payors to resolve issues, and accurately documenting communications and actions taken. The ideal candidate will have excellent communication skills, be...
-
Healthcare Claims Support Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoClaims Support Role OverviewThe Claims Support Analyst at Experian Health plays a vital role in ensuring the smooth operation of both claims and remit clearinghouses. This position requires collaboration with software development teams, customer support, enrollment, and payer services teams to monitor file activity and investigate claims or remit-related...
-
Healthcare Claims Operations Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob SummaryExperian Health is seeking a skilled Claims Support Analyst to join our team. As a key member of our revenue cycle management team, you will play a crucial role in ensuring the smooth processing of claims and remits for our clients.Main ResponsibilitiesProvide technical support to both Claims and Remit Clearinghouses, working closely with software...
-
Professional Healthcare Claims Resolution Specialist
hace 1 semana
San Francisco, Heredia, Costa Rica Auxis A tiempo completoAuxis is a fast-growing business process outsourcing provider seeking a highly skilled Healthcare Claims Resolution Specialist to support one of our largest accounts and leading provider of healthcare services.This esteemed organization serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually, making it a critical...
-
Appeals Claims Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoAppeals Claims SpecialistJob DescriptionExperian seeks a skilled Appeals Claims Specialist to join our team. As a strategic partner for our healthcare clients, this role will focus on analyzing and pursuing appeal opportunities with payers and networks, ensuring timely reimbursement and maximizing revenue.Key Responsibilities:Implements process for...
-
Healthcare Insurance Claims Specialist
hace 13 horas
San Francisco, Heredia, Costa Rica Auxis A tiempo completo**Job Summary:**Auxis is seeking a highly organized and detail-oriented Healthcare Insurance Claims Specialist to join our team. As a key member of our client's operations, you will play a vital role in ensuring the timely and accurate processing of insurance claims.About Auxis:We are a fast-growing business process outsourcing provider dedicated to...
-
Claims Support Operations Specialist
hace 3 días
San Francisco, Heredia, Costa Rica Experian A tiempo completoAbout the RoleWe are seeking a Claims Support Operations Specialist to join our team at Experian Health.Job OverviewThe Claims Support Operations Specialist will provide support to both Claims and Remit Clearinghouses, working closely with software development teams, customer support, enrollment, and payer services teams to monitor file activity and...
-
Claims Support Specialist
hace 1 mes
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob Title: Claims Support AnalystAt Experian Health, we're shaping the future of U.S. healthcare by driving innovations in revenue cycle management, identity management, patient engagement, and care management. As a Claims Support Analyst, you'll play a crucial role in ensuring seamless claims and remit processes for our clients.Key Responsibilities:Monitor...
-
Claims Support Specialist
hace 3 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoAbout the Role:The Claims Support Analyst will play a key part in monitoring file activity and investigating claims or remit related issues.Working closely with software development teams, customer support, enrollment and payer services teams, the successful candidate will track open issues, report to customer support or clients, and communicate updates to...
-
Healthcare Appeals Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob Title: Healthcare Appeals SpecialistAbout the Role:Experian is seeking a skilled Healthcare Appeals Specialist to join our team. In this role, you will be responsible for monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.Key Responsibilities:Implement a process for...
-
Claims Reimbursement Specialist
hace 3 días
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob SummaryWe are seeking a skilled Claims Reimbursement Specialist to join our team in Costa Rica. This permanent home-based role requires strong analytical and communication skills, as well as experience working with managed care claims and appeals.Key ResponsibilitiesIdentify and pursue appeal opportunities with payers and networksAnalyze EOBs for...
-
Insurance Claims Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Auxis A tiempo completoRole Summary:You will be working for Auxis to provide support to a leading healthcare services provider. This provider serves a large number of hospitals and physician practices with numerous patient encounters annually.Key Responsibilities:As a Tri-Care Clerk, you will review customer accounts and identify discrepancies between expected costs and payer...
-
Healthcare Appeals Specialist
hace 2 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoAbout the RoleWe are seeking a skilled Healthcare Appeals Specialist to join our team at Experian. In this role, you will be responsible for monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.Key ResponsibilitiesImplement processes for identifying under-allowed claims...
-
Healthcare Appeals Specialist
hace 3 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob Description The Healthcare Appeals Analyst plays a pivotal role at Experian in ensuring accurate reimbursement for healthcare professionals. As a key member of our team, you will be responsible for identifying under-allowed claims, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance. Essential...
-
Healthcare Appeals Specialist
hace 4 semanas
San Francisco, Heredia, Costa Rica Experian A tiempo completoJob SummaryThe Healthcare Appeals Analyst plays a crucial role in ensuring that our clients receive the reimbursement they deserve. As a key member of our team, you will be responsible for monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.Key ResponsibilitiesImplement...
-
Medical Claims Auditor
hace 1 día
San Francisco, Heredia, Costa Rica Experian A tiempo completoAt Experian, we strive to simplify healthcare using data-driven insights. Our culture values openness, innovation, and accountability, making it an ideal place for a Medical Claims Auditor.The role involves monitoring contractual allowances, analyzing appeal opportunities with payers and networks, and reporting appeals performance. Key responsibilities...
-
Claims Resolution Associate
hace 4 días
San Francisco, Heredia, Costa Rica Auxis A tiempo completoAuxis is a fast-growing business process outsourcing provider that supports leading healthcare services. This partnership serves 959 hospitals and 2979 physician practices, facilitating over 50 million patient encounters annually.As a Claims Resolution Associate at Auxis, you will analyze customer accounts to identify discrepancies between expected costs and...
-
Senior Accounts Payable Specialist
hace 4 semanas
San Francisco, Heredia, Costa Rica Baxter A tiempo completoAbout the RoleBaxter is a leading global healthcare company that is passionate about transforming global healthcare for years to come. We are seeking a highly skilled and experienced Senior Accounts Payable Specialist to join our team in the Accounts Payable area.Key ResponsibilitiesProvide support and high-quality service to the U.S., Canada, and LATAM...
-
Accounts Receivable Specialist
hace 4 semanas
San Francisco, Heredia, Costa Rica Cencora A tiempo completoJob SummaryCencora is seeking a skilled Accounts Receivable Specialist to join our team. As an Accounts Receivable Specialist, you will be responsible for identifying payment discrepancies, initiating collections or dispute resolution processes, and performing follow-up procedures as needed.Key ResponsibilitiesIdentify payment discrepancies and initiate...