Responsibilities
- Investigate the root causes of claim denials, resolve issues, and manage the appeals process, including direct communication with insurance payer representatives.
- Exercise independent judgment in adjusting claims, resubmitting corrected claims, filing appeals, and applying effective claim resolution strategies.
- Coordinate with internal departments such as Performance, Operations, and Sales, as well as clinical care center personnel when necessary.
- Partner closely with the Revenue Optimization team to verify that payments align with the terms of payer contracts.
- Engage directly with practice consultants and physicians to enhance the effectiveness of the revenue cycle.
- Contribute to meeting departmental daily and monthly performance targets through collaborative team efforts.
- Perform additional assigned tasks as needed to support billing operations.
Work Arrangement
Hybrid — 1200 Binz St Suite 1490 Houston TX 77004
Other
- This is a hybrid full-time position requiring on-site presence on Tuesdays and Thursdays.
- Employees typically work remotely on Mondays, Wednesdays, and Fridays, though schedules may change to accommodate internal meetings, training sessions, or conferences.
