1. How many years of hands-on appeals experience do you have, including all the investigation required to determine if an appeal is necessary?
2. Explain your active experience in the past two years with – AR, follow up, appeals, underpayments, payor knowledge, research accounts, medical terminology.
a. Does your resume reflect these skillset requirements within the last 2 years? (If not please update your resume to reflect this experience)
3. Can you provide an example of your experience with appealing denials? And resubmitting corrected claims? Underpayments?
4. Can you provide an example of a denied claim that you appealed? What steps did you take? (Please provide as much detail as possible)
5. Tell me about your experience in calling insurance companies daily checking status of past due claims? (They should know how to call BC/BS and Cigna as well as other payors to resolve claims.)
6. Tell me about your experience with using websites to check the status of multiple claims with the payors?
7. Tell me about your experience with reading an explanation of benefits?
8. Can you explain what the explanation of benefits provides?
9. Tell me about your experience with understanding medical terminology? Give examples.
10. Validate that you do not have any PTO scheduled during the first 90 days of the project.
11. Tell me about your experience in dealing with Medicare Managed Care and Medicaid Managed Care.
12. What MCO payers are you familiar with?
13. How successful have you been in collecting aged AR?
14. What is your experience what hospital /institutional claims
16. This position will be patient facing as well, do you have experience dealing with patients and getting corrected insurance information or taking and posting patient payments?
Review claims for accuracy of procedures, diagnoses, demographic and insurance information
Audited accounts to verify charge documentation, identifies patterns, make recommendations for work flow changes to reduce issues.
Be able to identifies potentials errors created by those related to claims processing, eligibility records and client submissions to improve the overall billing and reimbursements.
Must be detail oriented.
Job Type: Full-time
Pay: $1.00 - $24.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
- Weekend availability
Education:
- High school or equivalent (Preferred)
Experience:
- Accounting: 2 years (Required)
Work Location: Remote
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