Associate Underpayment Follow-Up Specialist

Job ID
2018-21673
Employment Type
full-time
City
Saddle River
Hours Per Week
0.00
State
NJ

Overview

The Associate Underpayment Follow-up Specialist will recover lost revenue for hospitals and physicians related to underpayments.  The individual will review accounts previously billed by the Underpayment Recovery Billing Specialists to managed care networks.  The Associate Underpayment Follow-up Specialist will review his or her work list to continue pursuit of underpayments verbally, electronically, or in paper format.  The rep will provide feedback to the Underpayment Billing Specialists as opportunities for improvement are identified.

 

Responsibilities

  • Reviews accounts appealed to managed care companies to continue pursuit of lost revenue.
  • Contacts appropriate managed care organization via phone, electronic communication, and paper to ensure expeditious processing of underpayment appeals
  • Where appropriate, aggregates underpayment trends for expedited processing
  • Manages assigned work list of underpaid accounts by utilizing Summit work flow tools
  • Provides feedback to Manager as well as Underpayment Billing Specialists regarding false positive and true underpayment issues
  • Maintains a high level of accuracy of follow-up while maintaining thorough and concise notes recording all communication with managed care companies
  • When necessary updates reason for pursuit and pursued amounts to accurately reflect current information
  • Maintains a positive tone to all communication with managed care representatives while discussing underpaid accounts
  • Carries accounts through to completion
  • When necessary, assigns the appropriate reason for account closure
  • Identifies additional reimbursement posted to accounts in billed statuses
  • Reviews accuracy of additional payments posted to accounts prior to submitting for invoicing
  • Utilizes payer portal websites, client patient account systems, internal technology to continually validate activity, payment accuracy, and account status

Qualifications

 

  • MinimumTwo-year degree
  • Experience reviewing and appealing managed care underpayments
  • Ability to review and understand managed care contract language and payment methodology
  • High degree of skill in contexts requiring negotiation
  • Familiar with ICD-9, CPT Coding, revenue codes, UB and HCFA billing formats
  • Knowledge of/experience working with provider billing
  • Experience working with customer support/client issue resolution management
  • Strong analytical acumen

About nThrive

nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we’ve combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
 
nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Us!

Not ready to apply? Connect with us for general consideration.