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Credit Research Specialist
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Job Description
- Req#: 416515
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Involvement in innovative clinical care and scholarly activities
- Access to a wide variety of specialties and academic programs
- Opportunity to contribute to the health of the community through patient services
What to Expect (Job Responsibilities):
- Maintain detailed knowledge of commercial and government payor contract guidelines
- Research insurance and patient credit balances to ensure accuracy
- Monitor payor performance and identify trends for management review
- Initiate refunds and recoups in compliance with payor and corporate guidelines
- Contact insurance companies to resolve issues related to overpayments
What is Required (Qualifications):
- High School Diploma or GED
- Minimum of two (2) years of job-related experience
- Knowledge of financial data analysis, Medicare and Medicaid regulations, and third-party reimbursement
- Proficient in aspects of reimbursement including benefit investigations and payer reimbursement policies
- Understanding of medical coding systems affecting claims payment adjudication
How to Stand Out (Preferred Qualifications):
- Completion of college-level business courses
#HealthcareServices #CareerOpportunity #InnovativeCare #CommunityHealth #HealthcareCareersAbout the company
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