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Team Lead – Prior Auths, Insurance Verification
Location
Washington
Posted
1 day ago
Salary
$25 / hour
Seniority
Senior
Job Description
Team Lead – Prior Auths, Insurance Verification
GetixHealth
• Review self-pay accounts to verify insurance coverage. • Analyze and resolve unpaid claims. • Contact insurance carriers for claim status and payments. • Research claims using online tools. • Gather and submit supporting documentation to insurance carriers. • Submit appeals when necessary. • Review and apply contractual terms. • Communicate with patients/guarantors to expedite claims. • Assist with special projects and additional duties as needed. • Ensure compliance with information security policies. • Monitor inventory and provide reporting on open claims. • Report security risks as per procedures.
Job Requirements
- 7+ years’ experience in a facility setting performing insurance follow-up/ denials management
- Knowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of Benefits
- Complete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelines
- Knowledge of Commercial, Governmental and third-party denials and appeals processes
- Knowledge of billing systems
- Must have effective organizational skills and a high attention to detail
- Medical terminology required
- Must demonstrate the ability to adapt to change, maintain professionalism in challenging situations, and work in a Business professional environment
- Medi-Cal knowledge a major benefit
- High school diploma or college degree from an accredited college or university
Benefits
- Comprehensive Health Coverage: Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment.
- Life and Disability Insurance: Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D.
- 401(k) Retirement Savings Plan: Eligible to participate in the company’s 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service.
- Paid Time Off (PTO): Accrue Paid Time Off starting on your first day of employment.
- Flexibility in Benefits: The company reserves the right to amend, modify, or terminate any benefits programs as needed.
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