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Payment Integrity Professional 2 - Wah In Ky, Wah In Wi Or In The Office In Puerto Rico

Payment Integrity Professional 2 - Wah In Ky, Wah In Wi Or In The Office In Puerto Rico
Empresa:

Humana Inc.


Lugar:

San Juan

Detalles de la oferta

Description The Payment Integrity Professional will support the Accounts Receivable Casework Department by managing the recovery efforts of aging accounts receivable towards assigned clients. Primary focus of this customer-facing role will be to initiate outbound collection calls and maintain ongoing communication thereafter with providers, insurance carriers and/or other third party vendors by phone and e-mail to facilitate and secure refunds on past due invoices for medical claim overpayments. Responsibilities The Payment Integrity Professional II will independently oversee a caseload of clients and deliver result-driven individualized solutions to obtain overpayment refunds in a timely and cost-effective manner. Will also be responsible for conducting daily outreach by phone and/or e-mail with physician leaders and billing administrators regarding the refund status and recovery of their accounts receivable. Responsible for effectively researching, tracking and curing outstanding overpaid accounts by ensuring all avenues of overpayment recovery are evaluated using established best practices, including facilitating partial payment plans, credits and write-offs for assigned clients when appropriate, as well as providing recommendations for clients/accounts to be placed for 3rd party collections. Access necessary information from various collections and claim payment workflows systems in order to effectively and confidently communicate the life-cycle of overpaid accounts, and reasoning behind the claim payment inaccuracy that occurred on overpaid claim. Maintain updated client outreach and follow-up schedules towards unresolved accounts for all assigned clients. Prepare regular accounts receivable reports and updates as required for assigned clients, in addition to recording updated and accurate client notations, cash flow projections, refund confidence ratings, and tracking of financial transactions to include broken promissory agreements. Responsible for cash balancing and reconciliation of refunds, in addition to maintaining daily, weekly and monthly financial reconciliation and reporting for assigned accounts. Verify that all financial transactions comply with financial policies and procedures. Maintain thorough and detailed knowledge of compliance and recovery laws regarding processing and recoupment to ensure compliance with state laws regarding all cash processes as evident through the collection cycle. Required Qualifications High school diploma or equivalent Minimum of 1 year work experience leading/influencing operational goals through issue resolution to achieve successful business outcomes. Prior experience working on phones and strong customer service skills. Enthusiasm and motivation is essential; a confident change-agent with effective and professional first rate communication (verbal, written & presentation) skills. Ability to independently organize and handle multiple priorities while maintaining strong attention to detail and accuracy. Preferred Qualifications Associate's Degree, or equivalent 3 years of relevant customer-facing experience in a contact center and/or consumer service industry environment. Prior experience working with accounting or finance Flexible, dynamic personality who works well in a team environment. Prior experience in independently realizing established business objectives in a fast paced, metric driven operational setting with abstract and limited guidance. Previous experience within a healthcare setting, in addition to strong understanding of accounts receivable life-cycle to include supporting systems, applications and processes. Proficient with essential Microsoft applications (Word, Excel & PowerPoint). Additional Information Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 SDL2017


Fuente: Adzuna_Ppc

Requisitos


Conocimientos:
Payment Integrity Professional 2 - Wah In Ky, Wah In Wi Or In The Office In Puerto Rico
Empresa:

Humana Inc.


Lugar:

San Juan

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