revology

Insurance

• Following up on outstanding accounts receivables and resolving payer denials to ensure accurate and timely reimbursement.
• Conduct timely and thorough follow-up with insurance payers via phone, portal, or written correspondence.
• Identify root causes of unpaid claims and take corrective action including claim corrections, resubmissions, appeals, and credit resolution.
• Escalate systematic or high-impact denial trends to leadership and collaborate with internal teams.
• Communicate barriers and opportunities to improve collections and reduce denials to leadership.
• Review and respond to insurance correspondence as needed.
• Engage with patients and/or guarantors as needed.

Insurance Follow Up Specialist

QA Engineer

• Reviewing coded accounts for compliance, quality, accuracy, and completeness
• Preparing quality reports and feedback for distribution
• Assisting with documenting coding policies and procedures
• Providing training and coaching to team members
• Identifying improvements and supporting optimization initiatives
• Complying with HIPAA and ethical coding standards

Quality Assurance Specialist, Coding Quality and Education

Systems Engineer

• Collaborates with cross-functional departments on projects in order to optimize system performance
• Will maintain the payer database in relation to 835 and 837 transactional activities through the clearinghouse and EHR
• Serves as a liaison between Services and IT to manage changes and/or issues with the clients electronic health record system
• Supports the planning, development, implementation and upgrading of related software
• Works closely with the Services team to design, configure, build and maintain work queues, claims edits, reporting, and other items specific to the clients electronic health record workflows
• Responsible for implementing new systems, software release, system enhancements, training and day-to-day user related system problems
• Provides training support for new and existing processes, in collaboration with other internal and external teams
• Leads meetings with internal and external customers including third party vendors in a professional manner
• Navigates several computer applications simultaneously; documents all actions taken in appropriate Revology and/or client systems
• Complies with and holds with utmost regard all compliance requirements to protect patient privacy and confidentiality
• Stays curious, kind and contributes positively to the Revology culture

Insurance Follow Up Specialist

Quality Assurance Specialist, Coding Quality and Education

Systems Analyst, Cerner