Managed Care Denials & Variance Rep - Choose your schedule!

We are hiring for a Managed Care and Denials Variant Representative to join our team in the Melville, NY area. We are seeking candidates who are a team player, organized, and someone who is both reliable and responsible. You will only be considered for this position if you match the listed qualifications. If you match the listed qualifications and feel you are a good fit for this position, apply today!

Please note: this is an in person position, but usually turns to hybrid

What's in it for you?

• Dental, health, vision
• Weekly Pay
• PTO

Hours:

Monday-Friday

• 730-330/8-4/830-430/9-5 (pick your own schedule)

Job Type: Contract to hire

Job Title: Managed Care and Denials Variant Representative

Pay: $22-27/hr

Available Location(s): Melville, NY

Overview

Under the direction of the Hospital RRC Supervisor/ Manager, the Hospital Patient Financial Services (PFS) Representative is responsible to review all assigned third-party and/ or patient accounts, ensure that responsible payers are billed and remit payment in a timely manner, and to document account/ claim status and actions appropriately in the patient accounting system(s). Identifies, communicates and escalates complex claim issues,

billing/ payment trends, and recommends solutions to leadership.

Key Responsibilities:

• Reviews hospital accounts assigned by system generated work-queues or reports to determine appropriate actions for moving accounts forward in the revenue cycle. Performs those actions such as initiating phone calls, submitting website inquiries, writing letters of appeal to payers and inquiries to patients, recommend write offs and adjustments, ensures that account balances are valued as per payers' contracts, . all in accordance with department policies and procedures.
• Meets and/or exceeds productivity and quality standards as set forth in the department's policies and procedures.
• Performs root cause analyses on accounts with a solutions focus; tracks trends and escalates carrier or revenue cycle system issues to the Team Lead and/or Supervisor.
• Participates in projects and audits as directed by leadership; collects and assembles financial documents related to billing and payment to substantiate services and reimbursement.
• Collaborates with internal departments, external vendors, and IT for issue resolution and operational effectiveness.
• Regularly meets with Team Lead/Supervisor to discuss and resolve billing obstacles, reimbursement issue, and process improvements.
• Monitors accounts for timely filing guidelines and prioritizes work accordingly. Ensures claims are compliant, meet payer requirements, and billing errors/ claim rejections are resolved timely so that financial losses are minimized. Escalates and reports any delays in claims adjudication.
• Assesses payments (or lack of) and adjustments for accuracy and timeliness. Understands and reviews payer reimbursement systems/ contracts to establish accuracy in the A/R. Reviews regulatory and contract updates to understand impacts to reimbursement from federal, state, and managed care payers. Corrects transactions and transfers balances to responsible parties as necessary in addition to reporting and documenting on-going issues to management.
• Promotes and delivers positive patient experience and patient satisfaction
• Performs other duties as assigned
• Adheres to all organizational policies and procedures.

Qualifications

• High school diploma (required)
• Strong payer experience in healthcare - 1+ year(s) minimum
• Strong denials experience in healthcare - 1+ year(s) minimum
• Background in insurance verification - 1+ year(s) minimum
• EPIC experience (highly preferred)

Apply today!!