Payment Variance Follow Up Representative

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Engage with payers through phone, email, fax, or online platforms to ensure the prompt resolution of outstanding claims.

• Conduct analysis of payment variances to pinpoint trends in underpaid claims.

• Recognize and report trends related to underpayments and claim denials.

• Initiate appeals when deemed necessary.

• Collaborate with patients, visitors, coworkers, management, and clients in a cooperative and courteous manner.

• Uphold confidentiality and maintain a professional demeanor.

• Utilize, protect, and disclose patients’ PHI in compliance with HIPAA regulations.

• Adhere to Information Security and HIPAA policies and procedures.

• Restrict viewing of PHI to the minimum necessary for fulfilling assigned responsibilities.

• Perform additional duties as required.

⛳️ Requirements

• A High School Diploma or equivalent is required.

• A minimum of 3 years’ experience in Commercial insurance collections, which includes submitting and following up on claims.

• Experience in Hospital/Facility billing is essential.

• Familiarity with the insurance follow-up process and basic concepts in healthcare reimbursement methodologies is necessary.

• In-depth knowledge of Managed Care reimbursement methodologies is required.

• Basic understanding of healthcare claims processing, including ICD-9, CPT, HCPC codes, and UB-04.

• Ability to analyze, recognize, and resolve issues that lead to delays in payer payments.

• Proficiency in MS Office Suite is expected.

• Excellent interpersonal, written, and verbal communication skills are necessary.

• Strong problem-solving abilities and creativity; capable of exercising sound judgment and making decisions based on precise and timely analyses.

• High integrity and reliability, with a strong sense of urgency and results-driven orientation.

• A gracious and friendly demeanor for customer service interactions.

• Must have a smartphone or electronic device that can download applications for multifactor authentication and security purposes.

• Ability to follow instructions, collaborate effectively with others, and manage stress efficiently.

🏝️ Benefits

• Competitive salary.

• Comprehensive health benefits.

• Opportunities for professional development.

• Supportive work environment.