Rcm Claim Reviewer I - Glen Allen, United States - HOME CARE DELIVERED, INC.

HOME CARE DELIVERED, INC.

Verified Company

Glen Allen, United States

4 days ago

Posted by:

Mark Lane

beBee recruiter

Description

Revenue Cycle Management Claim Review I
Ensures that Home Care Delivered, Inc. is properly reimbursed on claims it has submitted for payment. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and polices.

ESSENTIAL DUTIES
Researches and resolves issues with claims, including denials and appears for assigned payer group.

Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.

Effectively communicates with other revenue management staff and management, including potential changes to PayerPro, changes in fee schedule, need for prior authorization, etc.

Maintains appropriate level of communication and confidentiality.

Performs all other duties assigned, which may vary at any time with our without notice.

HCD VALUES

Must demonstrate the HCD Value Inspire-A high performing team united by a common purpose.
Must demonstrate the HCD Value Innovate-To relentlessly collaborate and improve.
Must demonstrate the HCD Value Be Compassionate-By always being kind, caring and respectful.
Must demonstrate the HCD Value Show Gratitude-By honoring our teammates, partners & customers.
Must demonstrate the HCD Value Act Boldlythrough dreaming big and moving with courage.

COMPETENCIES

Able to complete tasks in specified time frame.
Demonstrates strong organization skills and proven ability to multitask and manage time in order tomeet frequently changing deadlines in a fastpaced environment.
Demonstrates superior professional ethics and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete security.
Demonstrates excellent interpersonal, oral, and written communication skills.
Demonstrates excellent organizational skills as well as strong attention to detail.
Demonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workload.

Must demonstrate experience in Microsoft office and proficiency in claim management systems.

EDUCATION/EXPERIENCE

High School Diploma and/or GED required. Associates Degree, strongly preferred. Degree can be in general studies, accounting, finance or similar course of study. Four years' experience with HCD in revenue management can be substitute for the Associates degree.
Experience with insurance billing and/or collections required.