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Remote Account Specialist
|Company:||Convergent||Location:||Boca Raton, Florida, United States|
|Posted:||Monday, November 13, 2017|
Convergent Revenue Cycle Management Inc.
Account Specialist (Healthcare Reimbursement) – REMOTE POSITION, reporting to Boca Raton, FL Location.
Convergent employs a dedicated team of expert healthcare attorneys and Account Specialists who navigate the entanglements of the legal system to increase reimbursement rates for our client hospitals all over the country. We apply our advanced technology to calculate anticipated payment for claims in states with complex fee schedules, allowing us to accurately identify and appeal underpaid or denied claims. Our main goal is to assist hospital systems to strengthen their financial and clinical performance. We are also a leading provider of denial management, Workers' Compensation claims resolution, and appeals solutions.
Convergent’s Boca Raton FL Insurance Department has openings for a remote Account Specialist. This is an ideal opportunity for a healthcare professional looking for remote work as the successful candidate can work anywhere in the country and report to our Boca Raton, FL office.
Account Specialists work a caseload of accounts and report directly to a Supervising Attorney or Supervisor. You will be responsible for contacting insurance companies such as Aetna, Blue Cross, Cigna, verbally and in writing to appeal wrongfully denied or underpaid insurance claims. You will assess various payer contracts to validate payments received and to appeal denied or wrongfully delayed claims. Account Specialists perform appropriate follow up with payers and provide clear and concise documentation of actions taken on each account. You will utilize federal and state laws and statutes to formulate appeals, participate in settlement negotiations, identify client issues and address them appropriately, and maintain a working knowledge of assigned clients, states, and insurers.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform all duties satisfactorily in a remote setting. The requirements listed below are representative of the knowledge, skill and/or ability required.
- Strong analytical, problem-solving, and conflict resolution skills
- Excellent oral and written communication skills
- Must be able to read, review and analyze reimbursement contracts from managed care insurance
- Basic knowledge of CPT & HCPCS coding language required, ICD-9 & ICD-10 knowledge a plus
- Understanding of HMOS, PPOs and other Managed Care Plans
- Knowledge and understanding of UB04 and EOBs/RAs
- Must possess knowledge of third party reimbursement regulations and billing practices.
- Ability to communicate clearly and work effectively with co-workers
- Working knowledge of medical terminology and abbreviations, and healthcare nomenclature
- Maintain strictest confidentiality
- Required: 2 to 3 years minimum experience in healthcare reimbursement/collections
- Required: High School graduate or equivalent is required.
- Preferred: College degree preferred.
- Preferred: Associates or Bachelor’s Degree in Healthcare Management/Administration preferred
Hiring is contingent upon successful background check and drug screening.
Compensation: negotiable based on experience
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