RCM Claim Reviewer I

Home Care Delivered (HCD) is a rapidly growing specialty medical supply distributor that partners with physicians, home healthcare providers, and other healthcare practitioners by providing medical products to their patients, delivered directly to their homes anywhere across the U.S. HCD has contracts with hundreds of insurance companies including Medicare, state Medicaid plans and commercial insurance plans throughout the U.S. HCD offers a wide array of name-brand products across multiple chronic care categories, including Incontinence, Diabetes, Ostomy, Urological, Wound Care, Equipment and Oral Nutritional Supplements. These products are instrumental in assisting people to return home from a hospital stay or remain in the home setting. HCD has offices across the US and distribution that enables next-day delivery for 96% of the US population. Founded in 1996, HCD has a successful operating history and today employs over 300 teammates. HCD is guided by the company's purpose statement: To help people live with confidence and dignity. With a 98% customer satisfaction rating, is elevating the industry standard.

Due to the success of our organization, we are hiring a Revenue Claims Reviewer!  This is a remote position.

The Revenue Claim Reviewer ensures that Home Care Delivered, Inc. is properly reimbursed on claims it has submitted for payment. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and polices.

ESSENTIAL DUTIES:

• Researches and resolves issues with claims, including denials and appears for assigned payer groups.
• Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.
• Effectively communicates with other revenue management staff and management, including potential changes to PayerPro, changes in fee schedule, need for prior authorization.
• Maintains appropriate level of communication and confidentiality
• Performs all other duties assigned, which may vary at any time and without notice

REQUIREMENTS:

• High school diploma
• Experience with insurance billing and/or collections required
• Able to complete tasks in specified time frame.
• Demonstrates strong organization skills and proven ability to multi-task and manage time in order to meet frequently changing deadlines in a fast-paced environment.
• Demonstrates superior professional ethics and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete security.
• Demonstrates excellent interpersonal, oral, and written communication skills.
• Demonstrates excellent organizational skills as well as strong attention to detail.
• Demonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workload.

PHYSICAL REQUIREMENTS:

• Sitting: Ability to sit for extended periods, typically 6-8 hours a day, while working at a computer station.
• Manual Dexterity: Proficiency in using a keyboard, mouse, and other computer peripherals for data entry and communication purposes.
• Visual Acuity: Ability to view a computer screen for prolonged periods, with good visual acuity to read small print and accurately enter data.
• Hearing: Adequate hearing ability, with or without correction, to understand and respond to customer inquiries via telephone or other audio equipment.
• Repetitive Movements: Regular use of the hands, wrists, and fingers to perform repetitive tasks such as typing and using a mouse.

BENEFITS:

• Medical/Dental/Vision Insurance
• Health Savings Account
• Life Insurance
• 401K Plan
• Paid Holidays
• Competitive PTO schedule that includes vacation, sick, and personal days
• Paid training
• Casual dress code

Due to the high volume of applications we receive, we are unable to respond individually to each applicant. Rest assured, if your qualifications align with our needs, we will reach out to you directly to discuss the next steps. We request that you refrain from making phone calls to inquire about the status of your application. Thank you for your understanding and interest in joining our team.