Denial Management Specialist

The Patient Financial Services Specialist is responsible for efficiently working accounts receivable for the organization.

This is a full-time position working Monday-Friday 8:00am-4:30pm from our corporate office in Bloomington, MN.

Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. This position will be employed by Revo Health, working closely with Infinite Health Collaborative (i-Health) and its operating divisions.

Essential Functions:

• Ensure professional communication with patients, clinic personnel, and outside vendors over the phone, via email or other written documentation and respond to all inquiries
• Maintain a working knowledge of health care plan requirements and health plan networks
• Verify and document insurance information as defined by current business practices
• Accurately post all payments received from patients, attorney offices and/or insurance companies
• Review Explanation of Benefits (EOB), research denials, rejections and/or excessive reductions
• Ensure appropriate forms are used when requesting adjustments, insurance transfers or other specific account changes
• Prepare, submit and ensure timely claim accuracy for all physician billing to third party insurance carriers either electronically or via hard copy
• Make outbound phone calls to patients or insurance companies as follow up to unpaid, denied or rejected billing claims and document according to current policy
• Take inbound calls from patients or insurance companies as follow up to unpaid, denied or rejected billing claims and document according to current policy
• Review and work any credit balances to determine if patient and/or insurance company refund is applicable
• Any and all other duties as assigned

Education and Experience Requirements:

• High School diploma/GED or equivalent
• Previous experience in a healthcare facility in relation to accounts receivable or billing practices preferred

Benefits & Compensation:

• Actual starting pay will vary based on education, skills, and experience.
• We offer a comprehensive benefits package - to learn more clickhere.
• Employees working 30+ hours per week (60 hours per pay period) are eligible for our Medical (w/Maternity Bundle), Dental & Vision plans, as well as Tuition Reimbursement.
• All employees, regardless of hours, are eligible for 401(k) with Profit Sharing, Employee Assistance Program, Lifetime Fitness Subsidy, Car Rental discounts, Home, Auto, & Pet insurance savings programs & more.

Working Conditions:

• Office setting

Setting: Office

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices, and business ethics guidelines.
• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
• Demonstrate prompt and reliable attendance.
• Work at an efficient and productive pace, handle interruptions appropriately, and meet deadlines.Prioritize workload effectively.
• Communicate respectfully and professionally in face-to-face, phone and email interactions. Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions.

Notes

• Revo/ i-Health is an Equal Opportunity Employer. We are committed to fostering an inclusive and accessible workplace. Reasonable accommodation may be provided to enable individuals with disabilities to perform essential job functions. Applicants or employees who wish to request an accommodation may do so by emailing HR@RevoHealth.com. For more information, please review the Know Your Rights notice from the U.S. Equal Employment Opportunity Commission.
• We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: https://www.e-verify.gov/employees/employee-rights-and-responsibilities
• Please note: This job description is intended to describe the general nature and level of work being performed by individuals assigned to this position. It is not an exhaustive list of all duties, responsibilities, and qualifications required. Revo/ i-Health reserves the right to modify job duties or descriptions at any time, with or without notice, in accordance with applicable laws.