Job Description

*$2,000.00 Signing Bonus* -Eligible after 45 days of employment

Job Summary

We are seeking a detail-oriented and experienced Senior Hospital Collection/Appeal and Denial Representative to join our team. The ideal candidate will have a strong understanding of hospital claim denials, billing, coding, medical terminology and specifically skilled in complex aged claims collections. This role is crucial in ensuring timely collection of outstanding accounts while maintaining positive relationships with clients and healthcare providers.

About Us: ERISA Recovery is a fast-growing company based in Dallas, TX, specializing in the recovery of aged and complex claims using the Federal ERISA appeals process. Our collaborative and innovative team offers an extraordinary opportunity for career growth in the ever-evolving revenue cycle industry. If you’re ready to advance your career with a company that values passion, precision, and teamwork, we want to meet you.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance
• Paid lunches
• Life insurance
• Gym access
• Bonus program

Key Responsibilities:

• Expertise in processing UB-04 hospital claims with a comprehensive understanding of hospital billing form requirements.
• Strong knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes .
• Thorough understanding of the revenue cycle process, including prior authorization, billing, insurance appeals , and hospital collections.
• Extensive experience with payor contracts and claim reimbursement policies.
• Independently review, submit, follow up on, and collect payments for denied hospital claims.
• Ensure denied hospital medical claims are resolved quickly and accurately.
• Communicate professionally and effectively with insurance companies and healthcare providers to expedite claims resolution.
• Draft and submit clear and concise medical appeals aimed at maximizing claim recoveries.
• Collaborate cross-functionally with internal departments and external stakeholders to optimize claim outcomes.
• Adapt and learn new systems and technologies to enhance the claims process.
• Meet daily, weekly, and monthly performance benchmarks to ensure individual and team success.

Desired Skills and Qualifications:

• Bachelor’s degree preferred.
• 5-10 years of experience in hospital medical billing, collections, and appeals; ERISA experience is a significant plus.
• Proficiency in computer applications, including Windows PC systems, and a willingness to adopt new technologies.
• Excellent verbal and written communication skills for clear and concise correspondence with all parties.
• Strong multitasking abilities, particularly in managing complex cases while maintaining high productivity and attention to detail.
• Exceptional organizational skills and the ability to meet deadlines in a fast-paced environment.
• A commitment to providing outstanding customer service to clients and internal teams.

Join us as we strive to improve our collections process while providing exceptional service within the healthcare sector!

Work Location: In person

Schedule:

• 8-hour shift

Ability to Commute:

• Plano, TX 75093 (Required)

Ability to Relocate:

• Plano, TX 75093: Relocate before starting work (Required)

ERISA Recovery is an Equal Opportunity Employer

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