Specialist II, RCM Collections

The role

This person will work on claims denials and resolve issues for correct processing to ensure financial accuracy. They will identify root causes and craft suggested fixes to reduce denial inflow within the RCM process.

What you will do

• Researching and finding solutions to denied claims.
• Completing portal inquiries and/or outbound calls to insurance reps to investigate denial reasons.
• Resubmitting claims with errors, utilizing knowledge of CMS 1500 forms and a broad understanding of data, coding, and policy errors.
• Drafting appeals for relevant claim denials, adhering to medical policies for all insurance carriers.
• Ensuring patient data in the software is correct and up to date, and contact the appropriate person for any inconsistencies.
• Prioritizing claim denials based on the internal Claim Prio Model.
• Flagging root causes and craft suggested fixes that can be made upstream within the RCM process to reduce denial inflow.
• Making bulk corrections to claim denials that span across multiple clients with the same denial type.

Required qualifications

• 3 years of Medical Billing experience.
• Proficient in multitasking and working through different systems.
• Strong at learning new processes and following the appropriate steps to seek resolution.
• Strong team player who can collaborate with peers and promote a positive working atmosphere.

Nice to have

• Experience at a start-up in Mental Health or Billing/Collections.

Benefits

• Comprehensive medical, dental, vision, life, and disability coverage.
• No cost access to therapy through the Grow platform (available to US employees).
• Retirement savings programs and equity opportunities.
• Flexible time off, company paid holidays, and a full company wide Winter Break.
• Up to 18 weeks of paid parental leave and a new child stipend.
• Dedicated weekly flexible time for self care.
• Annual stipend to support personal wellbeing and professional growth.
• Pre tax commuter benefits for teammates working from hub locations.
• Support for home workspace plus meal benefits.
• Wellness memberships, virtual care, pet insurance discounts, and global travel assistance.

Before you apply

• Please upload your resume in PDF format

About the company

Grow was born to tackle a critical challenge: making mental health care more effective and accessible for everyone. They operate a three-sided marketplace that empowers providers, augments insurance payors, and serves patients.