73 applicants
Vituity ยท 3 days ago
Appeals Processing Analyst (Payment Analysis)
Sacramento, CA
Full-time
Remote
Entry, Mid Level
$19.63/hr - $24.04/hr
2+ years exp
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Insider Connection @Vituity
Responsibilities
Analyze and process accounts following compliance guidelines.
Process payer correspondence request.
Verify patient account to ensure the accuracy of Financial Class, CID and INSKY.
Utilize internal and external applications and websites.
Verify explanation of benefits (EOB) have been posted correctly in the patient account.
Verify no exceptions exist and site matrix is applicable.
Validate claim to ensure correct provider was assigned.
Research provider status and eligibility on external websites.
Obtain payer fee schedule from external website.
Identify contract matrix discrepancies and/or gaps and communicate accordingly.
Process and/or apply activity code or PDR to account as applicable.
Verify documents, Email, mail or fax details to internal or external resources.
Collaborate with internal departments to resolve account discrepancy.
Update patient account to bill out insurance or balance to patient if applicable.
Contact the patient or insurance company on an account.
Identify trends and communicate to leadership team.
Other tasks as assigned by Supervisor or Manager.
Qualification
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Required
High School Diploma or GED required.
2+ years working experience at Vituity RCM required.
Possess strong interpersonal skills to work within a team environment.
Possess strong verbal and written communication skills.
Effective customer service skills with internal and external customers.
Ability to read and comprehend simple instructions, short correspondence, and memos.
Effectively present information in one-on-one or small group situations to customers, clients, or other employees.
Ability to correctly add, subtract, multiply and calculate percentages.
Ability to follow department and compliance guidelines.
Ability to work in a fast-paced environment.
Flexible and adaptable to an ever-changing environment.
Ability to make phone calls seeking account resolution.
Identify trends and communicate to manager or leadership team.
Experience handling debits and credits (reconciliation processes).
Effectively balance payer EOB's and/or allocate patient payments.
Ability to reconcile payer correspondence.
Perform 10-key by touch.
Ability to work proficiently within Microsoft Office; Word, Excel, Outlook.
Works collaboratively with another department or region.
Ability to work overtime during peak periods.
Preferred
CPU/AS400 or another billing system experience preferred.
Prior phone proficiency preferred.
Basic understanding of all department tasks preferred.
High level knowledge of RCM Operations preferred.
ICD 10 coding and CPT understanding preferred.
Other tasks as assigned by Supervisor or Manager.
Benefits
Superior health plan options
Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
Outstanding Paid Time Off: Four weeks' vacation, Paid holidays, Sabbatical
Student Loan Repayment Program
Professional and Career Development Program
EAP, travel assistance and identify theft included
Wellness program
Diversity, Equity and Inclusion (DEI) initiatives including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more
Purpose-driven culture focused on improving the lives of our patients, communities, and employees
Company
Vituity
Vituity is dedicated to bringing joy to the practice of medicine. As a nationwide, multispecialty partnership of top physicians
1,001-5,000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Harrington
Chief Executive Officer, Practice Management
Jeff Baldwin
CFO
Company data provided by crunchbase
