Denial and Claims Management:

Identify and analyze denial trends, using findings to suggest process and system improvements to prevent future issues

Research and resolve unpaid, denied, and rejected claims, including communication with payers and submitting denials as needed

Handle EDI transactions, including reconciliation of payer submissions, edits, and rejection reports

Partner closely with the Insurance Verification team to identify upstream impacts on claim processing

Collaborate effectively with team members and other departments to support organization goals and implement process improvements

Collections and Payment Resolution:

Complete collection activities in compliance with payer guidelines and filing limits, ensuring actions are thoroughly documented

Review posted payments and process account adjustments as appropriate

Customer Support and Continuous Improvement:

Monitor patient accounts for non-payment, delayed payment, and billing irregularities, maintaining accurate records and taking appropriate steps for resolution

Investigate and respond to patient billing inquiries

Revenue Cycle Specialist - Remote

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Brave Health

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