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
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