1+ months

Healthcare Billing & Recovery Agent "Medicaid COB/Recovery"

Regular Full Time


**Available for hire in locations that are within a commutable distance to: Sunrise, FL., Nashville, TN., Lathrop, CA., Chicago, IL., San Angelo, TX., Houston, TX. and Dallas, TX

Performant is a market leader that recovery services for healthcare.  Were more than brick and mortar we are about helping people. Its a dynamic, fast-paced and fun workplace like a start-up, but with the backing of a profitable public company with a history of growth.

We are looking for highly-skilled, talented medical billing  and collections specialists with strong knowledge of medical claim billing, forms UB04, UB05 and CMS 1500, medical terminology and medical coding, Coordination of Benefits and Third Party Liability (COB/TPL) and procedural challenges regulations; experienced in generating or auditing medical claims and billing; proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues; and communicate effectively with carriers to recapture payments. 

As a Healthcare Billing and Recovery Agent you will be assigned client carrier accounts with responsibilities to include, but not limited to:
Contact Healthcare Insurance carriers and/or providers regarding improperly paid claims
Educate Healthcare Insurance carriers and/or providers on their obligation to pay
Ability to analyze and understand written communication from insurance companies including explanation of benefits.
Support internal groups or functions with gathering and interpretation of the billing and collections work to development with knowledge base and understanding of key concepts and terminology in healthcare billing and claims
Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance carriers and/or providers
Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management.
Leverage your knowledge and expertise to research Coordination of Benefits or underpayments and  answer questions and/or provide information that will bring to successful resolution and payment
Initiate applicable action and documentation based upon provider/insurance carriers selected 
Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable
Arrives to work on-time, works assigned schedule, and maintains regular attendance
Follows and complies with company and departmental policies, processes and procedures
Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations
Successfully completes, retains, applies and adheres to content in required training as assigned 
Consistently achieve or exceed established metrics and goals assigned
Demonstrates Performant core values in performance of job duties and all interactions
Correct areas of deficiency and oversight received from quality reviews and/or management
Performs other duties as assigned.

**Notes - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

- Covid 19: Must be able to meet requirements for and perform work assignments in accordance with Company policies
and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company. 

Required Skills and Knowledge:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Below are representative of the knowledge, skills and abilities required:

Knowledge and experience with medical claim billing procedures, medical terminology and medical coding
Familiarity with information in the UB04/UB05 and CMS 1500 billing forms
Experience with Coordination of Benefits and Third Party Liability and Procedural Challenge regulations
Proven ability to gather and interpret Explanation of Benefits (EOB) and answer questions and resolve issues with payment
Communicate professionally and effectively with providers, insurance carriers and third party agencies regarding mistaken payments 
Experience in handling health insurance collections, including Medicare and Medicaid claims
Protected patients privacy, understands and adheres to HIPAA standards and regulations 
Interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service attitude
Capacity to share knowledge and educate others on healthcare billing and collections in relation to terminology, procedures, and related information
Self-motivated and thrives in a fast-paced office environment performing multiple tasks cohesively, with keen attention to detail
Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset.
Ability to follow process, procedures and regulations in the workplace.
Ability to effectively perform work independently, and work cooperatively with others to promote a positive team environment.
Capable of adapting quickly and transition effectively to changing circumstances, assignments, programs, processes.
Ability to consistently perform job responsibilities.
Possess a personality type that is ethical, friendly, hard-working and proactive.

Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Physical Requirements:

Job is in a busy standard office environment with moderate noise level, sits at a desk during scheduled shift, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse. Reads and comprehends information in electronic (computer) or paper form (written/printed).
Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment
Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts
Consistently communicates on the phone with account holders, may dial manually when need or use dialer system; head-set is also provided
Occasionally lift/carry/push/pull up to 10lbs.
Education and Experience:
Minimum 2 years of medical billing and collection experience demonstrating depth of knowledge and capability required for the position. 
High School diploma or GED


Employment VISA Sponsorship is not available for this position and authorization to work in the United States is required prior to employment. 

Remote work may be available for this position.
Job Profile is subject to change at any time.

EEO - Performant Financial Corporation is an Equal Opportunity Employer.

Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 


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Posted: 2021-01-26 Expires: 2021-06-06
Analytics, audit, and recovery services for healthcare, government and student loans.

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Healthcare Billing & Recovery Agent "Medicaid COB/Recovery"

Performant Financial

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