Payment Integrity Specialist I

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

No

Job Summary:

Serves to ensure Geisinger collects full reimbursement due from payers. Responsible for analyzing patient claims through the use of designated tool(s) to identify where expected reimbursement does not match actual reimbursement. Appeals under payments, over payment, rejected/denied claims via telephone, rebilling, online adjustment or written correspondence to insurance company.

Job Duties:

• Serves to ensure Geisinger collects full reimbursement due from payers.
• Responsible for analyzing patient claims through the use of designated tool(s) to identify where expected reimbursement does not match actual reimbursement.
• Appeals under payments, over payment, rejected/denied claims via telephone, rebilling, online adjustment or written correspondence to insurance company.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details:

Education:

High School Diploma or Equivalent (GED)- (Required), Associate's Degree- (Preferred)

Experience:

Minimum of 3 years-Healthcare (Required)

Certification(s) and License(s):

Skills:

Communication, Computer Literacy, Group Problem Solving, Multitasking, Organizing

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family. 

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all.  We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.