This is a fully remote position, open to applicants in United States.

📋 Description

• Familiarize yourself with the Rubixis platform and its available resources.

• Successfully manage assigned accounts from initiation to completion within set timelines.

• Communicate with healthcare insurance companies, affiliates, and providers to address contract or payment discrepancies.

• Evaluate contracts, billing, cash costs, pricing, and collections on accounts while adhering to billing regulations, policies, and procedures.

• Investigate insurance payments that differ from anticipated amounts.

• Collaborate with leadership and team members to verify, challenge, or provide insights and solutions based on trends.

• Serve as a mentor to Rep I and Rep II associates.

• Handle moderately complex insurance denials and underpayments using Rubixis AR Follow Up software.

⛳️ Requirements

• Minimum of 5 years of experience in Hospital Billing with follow-up expertise, possessing advanced knowledge of all payer types.

• Comprehensive understanding of Medicare payer rules and processes, including the ability to interpret denial reasons, file appeals to Medicare payers, and navigate Medicare portals.

• In-depth knowledge of insurance follow-up strategies for resolving unpaid, denied, underpaid, and rejected claims for healthcare providers.

• Experience with UB04 Facility Pricing and Reimbursement variances.

• Solid grasp of the revenue cycle.

• Basic familiarity with HIT systems such as EPIC, Paragon, Zirmed, or other billing systems.

• Strong problem-solving and analytical skills.

• Highly organized with a detail-oriented mindset.

• Bachelor’s or Associate degree required.

• At least 2 years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including an investigation into pricing and reimbursement variances.

• Extensive knowledge of Facility Reimbursement contracts, fee schedules, and reimbursement procedures.

• Proficient in MS Excel.