Responsibilities
- Review and assess denied Medicare primary insurance claims promptly to determine next steps.
- Initiate and manage the appeals process via Redetermination, Reconsideration, or Administrative Law Judge channels, adhering to applicable federal and state regulations.
- Conduct thorough investigations of patient medical records using document review and digital research methods.
- Analyze and summarize findings from medical documentation clearly and concisely, ensuring proper recordkeeping.
- Identify recurring issues, patterns, and systemic problems independently and report insights to management effectively.
- Ensure compliance with corporate policies, procedures, and security standards while carrying out all assigned tasks.
Requirements
- High School Diploma or GED equivalent.
- Five years of professional experience in medical billing or collections within private, public, government, or military sectors.
- Must be legally authorized to work in the country of employment without employer sponsorship for a work visa.
Nice to Have
- Strong verbal and written communication abilities.
- Accurate and efficient data entry capabilities.
- Prior experience working with medical records.
- Proven ability to collaborate effectively in team settings while also performing independently with sound decision-making.
- Skilled in communicating clearly and professionally with internal and external stakeholders.
- Consistent track record of meeting deadlines and maintaining expected productivity and quality standards.
- Solid understanding of accounting principles.
- Proficiency in using Microsoft Office applications.
Compensation
The estimated base pay plus variable incentive compensation range for this role is $46,377 - $56,684. Final offer may vary based on experience, location, and other relevant factors.
Work Arrangement
Remote - United States
Team
Collaborate with a global team of innovative and diverse professionals.
The Impact You’ll Make in this Role
- In this position, you will engage your analytical skills and collaborate with a diverse, global network of professionals.
- You will evaluate denied Medicare primary insurance claims promptly.
- You will file appeals through Redetermination, Reconsideration, or Administrative Law Judge processes in compliance with state and federal laws.
- You will proactively analyze patient charts using document review and computer-based research.
- You will research, summarize, and document findings from medical records accurately.
- You will identify issues, problems, and trends independently and communicate them effectively to leadership.
Supporting Your Well-being
- Comprehensive wellness and support programs are offered to promote physical and financial health.
- Compensation and benefits are benchmarked against industry standards to ensure competitiveness.
- For U.S. applicants: the expected total compensation range is $46,377 - $56,684, including base and eligible variable pay.
- Actual compensation may vary based on knowledge, skills, experience, training, and work location.
- Eligible employees may receive benefits including medical, dental, vision, health savings accounts, flexible spending accounts, disability and life insurance, voluntary benefits, paid time off, and retirement plans.
- More information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-Rewards
Global
Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.
Other
- Work location: Remote-United States
- Travel: May include up to 10% [domestic/international]
- Relocation Assistance: Not applicable
- This position does not require or expect work to be performed in the unincorporated areas of Los Angeles County.
- Applicants should remain vigilant against fraudulent job postings and recruitment schemes impersonating the company.
- All official email communications related to employment will originate from an @solventum.com domain.
- Prior to submission, you will be required to confirm agreement with the application terms.
Not available
