Performant is a market leader that recovery services for healthcare. We’re more than brick and mortar – we are about helping people. It’s 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.Contact Healthcare Insurance carriers and/or providers regarding improperly paid claims
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 Collections Agent you will be assigned client carrier accounts with responsibilities to include, but not limited to:
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.
Why you’ll want to join
You want to make a difference for yourself and others.
You’re not looking for a job, you want a career
You learn quickly and are adaptable – we provide paid training.
You are committed to excellence in all you do – quality and reliability are part of our core values.
You want to be part of a team that works hard and celebrates achievement - People are the key to our success.
Performant offers a competitive benefits package:
Core health benefits- Medical, Dental and Vision
Company-paid Life and AD&D
Other health benefit programs include supplemental Life, AD&D, short-term and long-term disability, Accident and Critical Illness, Identity Theft, and Flexible Spending Accounts
Employee Assistance Plan
Health Advocate Services
Beyond Work discount products and services
Additional benefit programs
11 paid holidays
Paid sick leave
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.
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
Must submit to and pass background check. Must not have any Federal or State liens resulting from County, State or Federal tax issues. Must not have any current defaulted student loans.
Must be able to pass a criminal background checks; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment lists.
Must submit to and pass drug screen.
Performant is a government contractor. Certain client assignments for this position may require additional background and/or clearances.
Job Profile is subject to change at any time.
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.