Follow-Up Associate – TriCare/TriWest

Job title:

Follow-Up Associate – TriCare/TriWest

Company

R1 RCM

Job description

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.As a Follow Up Associate, you will investigate and examine denial accounts using established methods to resolve issues. You will apply appropriate techniques to resolve applicable issues, follow through with unresolved accounts, and provide feedback to leadership.You will utilize your computer skills to troubleshoot issues within the assigned specialization group. An analytical mindset will help you conduct research and obtain appropriate information to determine overpayments on accounts. Prior experience in healthcare billing and claims will be advantageous in understanding the department.Here’s what you will experience working as a Follow Up Associate:

• Investigate and examine the source of denials using knowledge of charge master, AS4, ICD-9 coding, CPT coding, and EDI billing.
• Read and interpret expected reimbursement information from EOBs and understand legal parameters related to State and Federal Laws concerning plan benefits.
• Work closely with third-party payers to resolve unpaid claims and prove the medical necessity of patient admission.
• Collaborate with HIM and PAS across the enterprise to resolve adverse benefit determinations.
• Submit technical appeals and understand the CAU scope document.
• Maintain and follow all HIPAA and confidentiality requirements.

Required Qualifications

• High School diploma
• Experience in follow-up, billing, or related revenue cycle experience.
• Knowledge in government insurance

For this US-based position, the base pay range is $14.92 – $20.21 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering aR1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rightsTo learn more, visit:Visit us on#LI-Remote #LI-KW01 #TJ2022 #Healthcare

Expected salary

$14.92 – 20.21 per hour

Location

USA

Job date

Fri, 23 Aug 2024 03:50:51 GMT

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