Essential Duties and Responsibilities:
- Leverage data-mining and reimbursement modeling tools to review and identify underpayments/denials which are due for additional reimbursement from the payer
- Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
- Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standards in a persuasive manner
- Gain knowledge of general hospital policies and procedures, hospital underpayments, and revenue cycle maximization opportunities
- Ensures productivity and quality standards are met
- Participate in internal client meetings, contributing to a greater understanding of project and initiative progress
- Coaches/Partners with other team members
- Identify and research new placement concept opportunities
- Assist in client reporting
- Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
- All other duties as assigned
Requirements
Knowledge, Skills, Abilities:
- Strong analytical, technical, and creative problem-solving skills
- Demonstrated ability to analyze, understand, and communicate complex issues and trends.
- Demonstrated interpersonal skills. Ability to articulate goals clearly and expectations to team members and communicate results to MRI Management.
- Customer-service orientation with the ability to interact with a range of personalities independently and styles to establish effective relationships internally & externally.
- A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
- Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
- Ability to demonstrate high personal ethics consistently, integrity, prudence, energy, initiative, and self-confidence.
Education/Experience:
- Bachelor’s degree with Healthcare, Business, or relevant background preferred
- Relevant professional experience within the Hospital/Insurance industry preferred
- Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred
Benefits
Dental, Medical, Vision and 401K
