Claims Escalation Specialist (Medical Collections) - Fast Pace Health

Posting Title:Claims Escalation Specialist (Medical Collections)Overview:

About the Company

Fast Pace Urgent Care is rapidly growing and a leading provider of urgent care and primary care clinics across Tennessee, Kentucky, and Mississippi. With over 100 clinics and counting, Fast Pace Urgent Care provides quality care to our patients at a reduced cost in underserved rural communities, while fostering a culture of fellowship among our team members. We are committed to hiring compassionate, driven team members that will ensure our patients receive remarkable care.

Fast Pace offers a number of challenging and meaningful career paths, providing you with the opportunity to work with the best people, grow your career, and most importantly, make a difference in people’s lives.  We provide a competitive benefits package, including health, 401(k), PTO, and Holiday Pay.

 

Fast Pace Urgent Care is guided by the following core principles: Quality of Care, Teamwork, Friendliness, Empowerment, and Communication.

 

Job Summary

 

The Claim Escalation Specialist will perform the daily collections and management of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments. The Claim Escalation Specialist will provide effective customer service for all internal and external customers by using, excellent, in-depth knowledge as well as communicating effectively with team members and strong customer service. 

 

Responsibilities:

• Performs daily on collecting and managing of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments.
• Collaborates with Manager of Claims Escalation & Processing, and Director of Revenue services to report denial trends to ensure proper claim resolution.
• Collaborates with patients, vendors, and internal departments to resolve conflicts on accounts and resolve any outstanding claims for unapplied/unidentified invoices.
• Ensures accuracy in claims escalation (denials management) while adhering to all regulations.
• Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely resolution of claims in current Practice Management system.
• Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Collaborates with Manager of Claims Escalation & Processing to create new processes and procedures as needed to improve overall claims escalation process.
• Performs a variety of administrative duties including, but not limited to: answering phones, faxing and filing
• Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
• The ability to maintain friendly, cordial relations with fellow coworkers.
• The ability to build and maintain confidence and credibility with fellow coworkers.
• The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
• The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
• Ability to comply with Company standards of operations.
• Ability to adhere to the Core Values of the Company, of teamwork, communication, empowerment, quality of care, and friendliness.
• The ability to promote and maintain a respectful culture of employee, employer and business confidentiality.
• Perform other duties as assigned by management.

Experience Requirements and Preferences::

• 1-2 years of Medicare and Medicaid collections 
• Accounts Receivable experience 

Compliance:

Fast Pace is committed to the principle of equal employment and creating an inclusive environment for the benefit of our employees, our patients, and our communities.   We  are an equal opportunity employer and welcome job applications from qualified individuals without regard to race, creed, color, ancestry, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, marital status, parental status, genetic information or any other legally protected characteristics or conduct.

 

Please refer to links below for information regarding your rights under certain federal laws: 

https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf  

https://www.dol.gov/whd/regs/compliance/posters/eppac.pdf

 

 

Mississippi Residents Only:

In Mississippi, employers may require pre-employment drug/alcohol tests as a condition of employment. If Fast Pace engages in this practice, the law requires that Fast Pace notify applicants, in writing, upon application and prior to the collection of the specimen for drug and alcohol test, that they may be tested for “the presence of drugs [or alcohol] in their metabolites.” Miss. Code. Ann. § 71-7-3(5).

 

Applicants are limited to individuals from states, excluding the following:  California, Colorado, Hawaii, New Jersey, New York, Rhode Island, Washington, and the District of Columbia.

Brand Name:FastPace Health