• Job Description

  Req#: 1945787
  Job Title: Medical Denial Specialist (Part-time)
  
  About Us:
  
  First Stop Health provides care that people love® with our convenient, high-quality and confidential virtual care solutions - Telemedicine, Virtual Mental Health and Virtual Primary Care. We help our patients save time and money through compassionate care that's available 24/7 via app, website or phone.
  
  First Stop Health offers a comprehensive benefits package that includes various health and medical coverage options, dental and vision coverage, disability and life coverage, making healthcare easily accessible. For those that choose to waive medical coverage a monthly medical waiver allowance will be provided.
  
  First Stop Health offers a remote-first work environment and flexible paid time off, including Summer Fridays. Employer offers monthly phone stipend demonstrate the company's commitment to employee financial well-being. The First Stop Health membership benefit is another added perk for employees and provides Virtual Urgent Care, Virtual Mental Health, and Virtual Primary Care from their very first day!
  
  Job Description:
  
  First Stop Health is seeking a medical billing specialist proficient in contacting insurance companies for status of denials. Often time, you'll need to work with Clinical team to gather documentation and medical records to submit appeals or corrected claims in a timely manner. You'll utilize your knowledge of denials to assess and ensure services were billed correctly to insurance, providers, etc. This position will report to the Director of Member Experience.
  
  Responsibilities:
  
  
  • Contacting insurance companies and/or provider (e.g., labs, specialist.) to gain insight on why claim is being denied and submit an appeal for payment reduction, etc.
  
  
  
  • Field patient questions around their EOB and/or invoices
  
  
  
  • Actively management and follow-up with denial/claims and report suspected or emerging trends related to payer denials to manager
  
  
  
  • Follow up on submitted appeals through payer portals or phone calls to the payer.
  
  
  
  • Ensure compliance with all applicable regulations and guidelines.
  
  
  
  • Follow - up on any issues around patient complaints, etc.
  
  
  Requirements:
  
  
  • 2-5 years of experience talking with (and "wowing") customers
  
  
  
  • 2-5 years' experience with medical terminology, CPT codes, HCPS codes, ICD-10 codes, medical insurance terminology, payor mix and denial management
  
  
  
  • A heart for delivering excellent customer service
  
  
  
  • Ability to work independently in afast-pacedenvironment
  
  
  
  • Skillsand comfort in usingMicrosoftOffice
  
  
  
  • Intermediate level of Excel
  
  
  
  • Waystar experience is plus!
  
  
  First Stop Health is committed to diversity, equity, inclusion, and belonging. Research shows that women, people of color and other historically underrepresented groups tend to only apply to jobs in which they meet all of the job requirements. Unsure if you check every box? Apply. We'd love to consider your unique experiences and how you could make First Stop Health even better.
  
  To learn more about First Stop Health, visit www.fshealth.com.

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