Claims Escalation Specialist

Overview

In a way, that best supports our values, the individual is responsible for the daily activities of claims escalation (denials management) for Fast Pace. The Claim Escalation Specialist will perform the daily collections and management of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments. The Claim Escalation Specialist will provide effective customer service for all internal and external customers by using, excellent, in-depth knowledge as well as communicating effectively with team members and strong customer service. 

Why Choose Fast Pace Health?

Fast Pace Health is a growing company! You will have the support and mentoring you need to become the best Claim Escalation Specialist you can be! We will help you grow your professional goals, and can offer you a rewarding career path. We work as a dynamic team to surpass our business goals by ensuring our patients receive the best care possible in a positive environment. 

We offer competitive compensation and benefits such as holiday pay, PTO, medical, dental, vision and Work-Life balance, to name a few. 

As a Fast Pace Health employee you will have the opportunity to participate in community events and outreach programs. This includes, but is not limited to, seasonal parades, book drives, festivals, trunk or treating, fun runs, and more. We dress up for holidays and celebrate with pot lucks. At Fast Pace, our community is our family, and we are a family first community.

Responsibilities

Essential Functions:

• Performs daily on collecting and managing of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments.
• Collaborates with Manager of Claims Escalation & Processing, and Director of Revenue services to report denial trends to ensure proper claim resolution.
• Collaborates with patients, vendors, and internal departments to resolve conflicts on accounts and resolve any outstanding claims for unapplied/unidentified invoices.
• Ensures accuracy in claims escalation (denials management) while adhering to all regulations.
• Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely resolution of claims in current Practice Management system.
• Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Collaborates with Manager of Claims Escalation & Processing to create new processes and procedures as needed to improve overall claims escalation process.
• Performs a variety of administrative duties including, but not limited to: answering phones, faxing and filing.
• Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
• The ability to maintain friendly, cordial relations with fellow coworkers.
• The ability to build and maintain confidence and credibility with fellow coworkers.
• The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
• The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
• The ability to comply with company standards of operations.
• Ability to adhere to all of the Core Values of the Company, of teamwork, communication, empowerment, quality care, and friendliness.
• The ability to uphold and maintain a respectful culture of employee, employer and business confidentiality.
• Perform other duties as assigned by management.

Experience Requirements and Preferences

Education:

• High School Diploma or its equivalent

AND

Experience:              

• 1 - 3 years in Claims Escalation (AR Denials) in a healthcare setting

Education Requirements

High School Diploma or Its Equivalent
Compliance

Fast Pace Health is committed to the principle of equal employment and creating an inclusive environment for the benefit of our employees, our patients, and our communities. We are an equal opportunity employer and welcome job applications from qualified individuals without regard to race, creed, color, ancestry, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, marital status, parental status, genetic information or any other legally protected characteristics or conduct.
Please refer to the links below for information regarding your rights under certain federal laws:
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/fmlaen.pdfhttps://www.dol.gov/whd/regs/compliance/posters/eppac.pdf
Mississippi Residents Only:
In Mississippi, Fast Pace requires pre-employment/drug/alcohol testing as a condition of employment. The law requires that Fast Pace notify applicants, in writing, upon application and prior to the collection of the specimen for drug and alcohol test, that they may be tested for “the presence of drugs [or alcohol] in their metabolites.” Miss. Code. Ann. § 71-7-3(5).

Applicants are limited to individuals from states, excluding the following:  California, Colorado, Hawaii, Illinois, New Jersey, New York, Rhode Island, Washington, and the District of Columbia.