Trend Health Partners · 4 hours ago
Provider Services Analyst I
United States
Full-time
Remote
Entry Level
2+ years exp
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Responsibilities
Maintains quality service by following corporate customer service practices and protocols
Analyze claims to determine the validity of recovery options
Draft detailed & convincing correspondence to effectuate reimbursement
Contacting insurance carriers, patients, attorneys, and employers to facilitate reimbursement
Contract interpretation as it relates to reimbursement, timelines, and verbiage of payer responsibilities guidelines to be followed
Use of payer portals and other technologies to advance time to revenue
Be able to identify defined root causes and trends from client inventories to formulate recovery resolutions or next steps in best practices
Clearly and concisely document all actions taken to the resolution of each claim within a claims recovery system
Qualification
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Required
Self-motivated and able to work independently and within a team structure
Ensures legal compliance by following guidelines, account contract, and the company's business plan
Maintains quality service by following corporate customer service practices and protocols
Analyze claims to determine the validity of recovery options
Draft detailed & convincing correspondence to effectuate reimbursement
Contacting insurance carriers, patients, attorneys, and employers to facilitate reimbursement
Contract interpretation as it relates to reimbursement, timelines, and verbiage of payer responsibilities guidelines to be followed
Use of payer portals and other technologies to advance time to revenue
Be able to identify defined root causes and trends from client inventories to formulate recovery resolutions or next steps in best practices
Clearly and concisely document all actions taken to the resolution of each claim within a claims recovery system
Possession of a High School Diploma with some college
2-5 years of experience within the healthcare market
2-5 years experience in navigating EMR and Patient Financial related software support systems
Preferred
Experience in DC, Maryland, Virginia markets strongly preferred
Prior experience reviewing, processing, and recovering in patient or outpatient clinical/technical post-service denials preferred
Multi-state Knowledge of payer requirements preferred but not required specifically in appeal guidelines and timeframes
Knowledge of UB04s and Claim Adjustment Reason Codes (CARC) and Reason Adjustment Reason Codes (RARC) is preferred
Ability to resolve claims by composing a compelling appeal letter; guiding resolution of non-routine claims; auditing claims with decision resulting in a high overturn rate
Prior experience navigating EMRs (Cerner, Epic, etc.) and patient financial systems
Strong ability to effectively multi-task
Superior verbal, written, customer service, and analytical skills with resolution is preferable
A continuous drive to stay abreast of healthcare industry policies and regulations
Understanding of medical terminology used in administrative and clinical documentation is preferable
Familiarity with Microsoft Office products
EPIC and Cerner experience a plus
Previous experience within an acute care or outpatient environment of revenue cycle
Benefits
Health insurance
401(k) plan with employer match
Paid parental leave
Company
Trend Health Partners
Trend Health Partners is an employee owned company that provides payment accuracy services for people.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknownKey Investors
Lone View Capital
2023-01-09Private Equity· Undisclosed
Leadership Team
Sarah Armstrong
Chief Executive Officer
Max Watson
Chief Financial Officer
Recent News
Company data provided by crunchbase
