Operations Associate – Resolution

Operations Associate – Resolution

Requirements

• Demonstrated experience in data analytics, healthcare billing, or revenue cycle management
• Organized and analytical self-starter with strong critical thinking skills and attention to detail
• Ability to verbally convey specific ideas and document detailed descriptions of work completed

Responsibilities

• Conduct follow-up calls and payer portal escalations with insurance companies to resolve underpaid hospital claims and maximize reimbursement for hospital clients
• Maintain timely, professional follow-up and demonstrate a wide knowledge base on a variety of risk areas and contractual underpayment issues
• Analyze and interpret denial data to develop evidence-based responses for claim/appeal denials to ensure contractual payment of submitted claims
• Perform continual analysis and quality control of underpayment risk areas to ensure audit accuracy
• Analyze payer trends and patterns identified during payer interactions identify opportunities for process improvement and implement effective solutions

Preferred Qualifications

No preferred qualifications provided.