Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; Actions include but are not limited to remit and EOB review, calling payer(s) and clinics, rebilling claims, navigating payer portals, and taking adjustments in the billing system
Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayments and follow appropriate documented policy and procedure to remediate
Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
Stay current on communication relating to healthcare reimbursement and regulatory changes
Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
Works well under pressure in a fast-paced environment, meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
Requirements
High school Diploma or equivalent (required)
Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook (required)
1+ years general accounting or algebra math skills (required)
Healthcare and medical billing/collections/denial remediation or refund experience (preferred)
1+ years of experience with generic accounting, transactions, or medical billing systems (preferred)