Insurance Collections Representative - HMS DBO

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

The Insurance Collections Representative is responsible for following up directly with commercial and government payers to resolve billing issues and secure appropriate reimbursement in a timely manner. This individual identifies and analyzes denials and payment variances, then enacts corrective measures as needed to resolve the errors. This role is a remote position supporting a virtual business office. As such, this role requires frequent and effective communication via phone, email, and instant messaging with the various engagement teams. Strong oral and written communication skills, analytical skills, ability to work independently, and be self-motivated are required.

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Duties and Responsibilities:

Examines denied and underpaid claims to determine reasons for discrepancies from expected reimbursement

Provides payers with specific reasons for suspected underpayments and analyzes the given denial reasons by payer

Works with management to identify, trend, and address root cause of denials, helps pinpoint strategies for reducing A/R

Effectively handles all communications, including telephone, electronic, and paper correspondence from payers and departments within the business office

Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress

Maintains a thorough understanding of federal and state regulations, as well as specific payer requirements and explanations of benefits, in order to identify and report billing compliances issues and payer discrepancies

Reports all identified compliance risks to appropriate leadership

Other duties and responsibilities as assigned.

Reporting and Supervision:

The Insurance Collections Representative will report to an HMS Manager

Qualifications:

Candidate Requirement:

Current permanent US work authorization required

Two years of appropriate work experience that would indicate a high level of communication skills and knowledge of the modern revenue cycle

Broad Knowledge of Government Programs and Insurance Regulations

May be requested to work overtime and/or weekends to fulfil client requirements

Knowledge, Skill, and Ability Requirements

Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint)

Ability to pay close attention to details; strong follow-up and follow-through skills

Requires the use of independent judgment, discretion and decision making abilities

Ability to interact with internal and external customers in a professional manner

Ability to ramp up on a client's environment, processes, historical context, and systems to provide support to an engagement as soon as possible

Demonstrates a solid understanding of and adheres to all Huron Healthcare compliance program requirements

Work Environment:

• This job operates in a professional office environment.
• This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands:

• This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time.

The estimated salary range for this job is $19.23-$25.00/hour. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron's benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

Position Level

Analyst

Country

United States of America