Specialist II, RCM Collections

This position will help ensure Grow's financial accuracy by working claims denials and resolving issues for correct processing. The role involves identifying root causes and crafting suggested fixes to be implemented upstream within the RCM process to reduce denial inflow, and making bulk corrections to claim denials that span across multiple clients with the same denial type. This role is fully remote.

Responsibilities

Researching and finding solutions to denied claims; Completing portal inquiries and/or outbound calls to insurance reps to investigate denial reasons; Resubmitting claims with errors, utilizing knowledge of CMS 1500 forms and a broad understanding of data, coding, and policy errors; Drafting appeals for relevant claim denials, adhering to medical policies for all insurance carriers; Ensuring patient data in the software is correct and up to date, and contacting the appropriate person for any inconsistencies; Prioritizing claim denials based on the internal Claim Prio Model; Flagging root causes and crafting suggested fixes that can be made upstream within the RCM process to reduce denial inflow; Making bulk corrections to claim denials that span across multiple clients with the same denial type; Reporting directly to the Supervisor, Collections, and working closely with the 4 Pods with Collections Follow-up

Requirements

3 years of Medical Billing experience; Technical Skills - proficient in multitasking and working through different systems; Process-Driven - strong at learning new processes and following the appropriate steps to seek resolution; Strong team player who can collaborate with peers and promote a positive working atmosphere; Experience at a start-up in Mental Health or Billing/Collections

Benefits

Comprehensive medical, dental, vision, life, and disability coverage; No cost access to therapy through the Grow platform (available to US employees); Retirement savings programs and equity opportunities; Flexible time off, company paid holidays (which vary by country), and a company wide Winter Break; Up to 18 weeks of paid parental leave and a new child stipend; Dedicated weekly flexible time for self care (Mental Health Mornings/Afternoons); Annual wellness and development stipend; Pre tax commuter benefits for teammates working from hub locations; Home office support and meal benefits; Wellness memberships, virtual care, pet insurance discounts (where available), and global travel assistance