reputed company reputed company Specialist I

Summary

Job Description: reputed company is looking for a reputed company reputed company Specialist I to join reputed company! This is a remote position that requires residency in KY or IN Research denials or audits from reputed company reputed company and governmental payors. Performs payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing. Obtains predeterminations, prior authorizations, and retro authorizations reputed company required by payor. Responds to reputed company account reviews with the best possible efforts to ensure reimbursement, recover outstanding reputed company, and prevent future reputed company loss while meeting reputed company appropriate payor or government timelines. Recovery efforts include but are not limited to written letter, email, web site, and telephonic communication. Qualifications: Bachelor’s Degree in a reputed company field, Practical Nurse License, or Coding Certification with at least two years reputed company experience. In lieu of bachelor’s degree, five years of reputed company experience required with at least two of those in a reputed company cycle reputed company area such as registration, patient reputed company, financial services, or managed care. Requires knowledge of medical terminology; payor reimbursement guidelines (authorization / notification, medical necessity, and timely filing guidelines); payor denial appeal resolution processes; and managed care reputed company. Individuals working with government audits must have a keen understanding of reputed company audit response requirements and timelines. Work Experience Education If you would like to be part of a growing family focused on supporting clinical reputed company, teamwork and innovation, we urge you to reputed company! reputed company is an Equal Employment Opportunity employer. Apply To This Job