Patient Acct Rep Personal

Revenue Integrity A/R Representative

Resolv Health is seeking a skilled and experienced Revenue Integrity A/R Representative to join our Revenue Integrity & A/R team. You will work within the core product team to develop customer solutions, provide technical expertise and to help ensure the quality of product updates and maintenance fixes. This position will report to the Asst. Director RCM of our Resolv Health business unit.

What your impact will be:

o Handle mail, faxing, scanning and daily data entry.
o Perform weekly claim runs for secondary claims to be sent for processing.
o Resolve claims by submitting appeals/reconsiderations that are denied and/or underpaid by the insurance companies.
o Review previous actions taken on claim to determine reason for non and/or incorrect payment and take necessary action. Review denials and resubmit corrected claims in a timely manner.
o Utilize insurance carrier websites/portals to verify eligibility, determine denial reason and submit under verified insurance plan.
o Obtain resolution of claims paid at zero dollars by properly resubmitting with updated information such as medical necessity, diagnosis specificity, patient eligibility, and medical documentation.
o Submit required documents/medical records for further payor review while maintaining HIPAA confidentiality.
o Utilize insurance carrier websites/portals to check claim status and take appropriate action to adjudicate claim.
o Research payer to determine proper filing requirements per insurance.
o Contact payer to determine reason for no response on claim (if not found on website portal).

What we are looking for:

o Working knowledge of general healthcare billing.
o Previous medical insurance payment follow-up.
o Great written and verbal communication.
o Works efficiently in a fast-paced environment.

o Strong attention to detail.

What would make you stand out:

o 3-5 years’ experience of professional and facility healthcare billing.
o Understanding of Managed Care and Government reimbursement methodologies.
o Experience of facility healthcare billing.
o Intermediate experience with Microsoft Excel.

What we can offer:

• Opportunity for challenging projects and professional growth

• Comprehensive benefit package

• Lifestyle rewards

• Flexible work options

About us:

Resolv Healthcare, a Harris Revenue Cycle Business - We are a leading provider of technology-driven solutions that transform patient experience and financial performance for healthcare organizations. Our Mission is to provide healthcare organizations service and software technology solutions to enhance patient experience, financial performance, and productivity.