(877) 505-1973 info@accountantsone.com
  • Contract
  • Atlanta, GA
  • ID: 39366
  • Salary: $20

Description:

One of Atlanta’s top healthcare companies is looking for a underpayment contract representative.

Key Responsibilities
  • Ability to read & interpret a paper contract and apply the language to a claim
  • Ability to manually calculate a claim based on contract language
  • Keep up to date with contract updates
  • Understanding of different insurance plans
  • Calculate Stop Loss manually (1st Dollar & 2nd Dollar)
  • Understanding of DRG, Carve Outs, Outliers, etc.
  • Analyze accounts thoroughly to move the account to the next step of resolution
  • Write an appeal for denied and/or underpaid accounts
  • Review an EOB & determine the underpayment
  • Contact the payer & able to provide a clear explanation on the claim issue to determine next steps
  • Identify payer issues (track & trend)
  • Clear & concise account notations that provides an explanation of what was done on the account, and next steps to be taken and what $ amount is being pursued that hasn’t been paid
  • Decision making skills
  • Work Over payments
  • Determine when to escalate a claim issue
  • Provide feedback than can assist staff & upper management
  • Basic knowledge of Excel spreadsheets
MINIMUM EDUCATION REQUIRED:
High School graduate or GED equivalent.
Minimum Experience Required
At least two (2) years prior related healthcare Revenue Cycle experience, preferably within denials/underpayments.
Prior experience using Epic preferred.

 

Questions? 

If you have questions or need assistance, please contact Bumi Oluwatimilehin

Tagged as: A1 Healthcare Partners

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