Managed Care Variance Collector

Company :

Job Description : 

GENERAL OVERVIEW:

This job is responsible for ensuring correct payments from payers with the goal of identifying payment variance and billing process issues to improve collections and cash receivables for AHN.

ESSENTIAL RESPONSIBILITIES:

• Reviews denials and payments in assigned work queues.  Performs audits, adjusts accounts, and handles appeals process.  (40%)
• Identifies and prevents denial patterns with internal teams and payers.  (30%)
• Coordinates with other departments to resolve payer and customer issues. (15%)
• Escalates issues to management as needed. (10%)
• Works AR projects as assigned. (5%)
• Performs other duties as assigned or required. 

QUALIFICATIONS:

Minimum

• High School/GED
• 5 years of hospital billing, coding, and/or financial analytics experience
• Proficient in Microsoft Office, including Excel
• Communication - Verbal and Written 

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Preferred

• Familiarity with EPIC

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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