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About FinThrive
FinThrive is advancing the healthcare economy. We rethink revenue management to pave the way for a healthcare system that ensures every transaction and patient experience is addressed holistically. We're making breakthroughs in technology-developing award-winning revenue management solutions that adapt with healthcare professionals, freeing providers and payers from complexity and inefficiency, so they can focus on doing their best work. Our end-to-end revenue management platform delivers a smarter, smoother revenue experience that increases revenue, reduces costs, expands cash collections, and ensures regulatory compliance across the entire revenue cycle continuum. We've delivered over $10 billion in net revenue and cash to more than 3,245 customers worldwide. When healthcare finance becomes effortless, the boundaries of what's possible in healthcare expand. For more information on our new vision for healthcare revenue management, visit finthrive.com
Award-winning Culture of Customer-centricity and Reliability
At FinThrive we're proud of our agile and committed culture, which has led to certification as a "Great Place to Work" since 2017. We're honored to have been ranked #21 among the Best Workplaces in Healthcare for 2023, and we know that it's our collective dedication that makes FinThrive an exceptional place to work.
- Find balance with our remote-friendly organization
- Take time to recharge and pursue your passions
- Be part of a positive and supportive work environment
- Grow and excel your career with training and education
Our Perks and Benefits
FinThrive is committed to continually enhancing the employee experience by actively seeking new perks and benefits. For the most up-to-date offerings visit finthrive.com/careers-benefits.
Impact you will make
Reps typically demonstrate the aptitude and ability to take on critical processes while managing quality production standards. Acts as a mentor to Rep I associates. Responsible for managing moderately complicated insurance denials and underpayments via the Rubixis AR Follow Up software.
What you will do
- Learn and understand our ARO platform and the various resources available.
- Work an assigned number of accounts from start to finish successfully, and in a timely manner.
- Call healthcare insurance companies, their affiliates & providers to resolve any question about contract or payment issues.
- Analyze contract, billing, cash costing, pricing, and collections on accounts in compliance with billing regulations, policies, and procedures.
- Investigate all insurance payments that deviate from expected payment
- Work collaboratively with leadership and other team members to confirm, challenge, or provide trending and solutions
- Accurately document outcome of all research and work performed on accounts or sub accounts in the system
- Accurately use system status codes, follow-up, and mark ahead responses
- Escalate items as appropriate to senior staff or management when appropriate
- Perform validation of bulk underpayment or denial trends
- Follow-up on mid dollar balances (Based on project criteria)
- Create appeals, patient, or payer correspondence
- Maintain full compliance with all regulatory guidelines (HIPAA)
What you will bring
- 3+ years of experience with healthcare insurance billing, follow-up, and collection in a hospital, clinical or BPO vendor environment with a proven track record of success in reimbursement and follow up
- Knowledge of Medicaid payer rules, processes, including how to interpret denial reasons, how to submit appeals to Medicaid payer, and access Medicaid portals
- Basic understanding of HIT systems like EPIC, Paragon, Zirmed or other billing systems
- Able to effectively resolve higher complexity denials and underpayments
- Ability to understand and use payer contract language in calls with payers
- Basic understanding of the healthcare revenue cycle in a hospital or clinical setting
- Intermediate to advanced understanding of insurance billing, reimbursement and follow up processes
- Familiarity with different payer types for claims processing and adjudication
- Ability to identify, understand and use general medical billing terminology including:
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- Claim types (UB/1500)
- CPT, ICD, DRG Codes
- EOB/RA
- Proficient understanding and interpretation of information and terminologies contained in payer correspondence
- Excellent written and verbal communication
- Proficiency with basic mathematic functions (addition, subtraction, multiplication, division)
- Problem-solving and organizational ability
- Able to consistently maintain or exceed minimum average daily productivity & quality after 90 days
- Understanding of Patient Accounting system/EMR
- Skills for MS-Office (Word & Excel) applications
What we would like to see
- Degree in related field
- Certification in billing or medical coding
- 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of both pricing and reimbursement variances
- 2+ years of experience with Medicaid processes and systems
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- Pay Type Hourly
- Travel Required No
- Travel % 0
- Telecommute % 100