Job Description:
• Resolve incoming rejections for the Mom & Baby division
• Analyze rejection data and insurance payment trends to identify patterns, trends, and the root cause
• Correct claim data as per payer requirements (e.g., modifiers, diagnosis codes, HCPCS, NPI, etc.)
• Maintain detailed records of all rejection cases, resolutions, and follow-up actions
• Verify eligibility, coverage, and authorization when needed to prevent future denials
• Assist with other projects for claims that have been denied or rejected
• Collaborate with our billing team and leadership
Requirements:
• High school diploma or GED
• Ability to understand difference between HCPCS, CPT, and ICD-10 codes
• Familiarity with payer portals, EDI systems, and clearinghouses
• Ability to multi-task
• Exposure to Google suite, Microsoft platforms
Benefits:
• Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!!