Healthcare Receivables Staff Attorney
Job Summary: Are you an individual who thrives in an organization that is growing and evolving? Is the word “change” exciting to you? If so, we are looking for an individual such as yourself to join our team. You will be responsible for performing research and confirmation on denied hospital accounts, successfully working with insurance companies via phone as well as the preparation and writing of appeal letters and the associated follow up activities in order to obtain additional reimbursement for our Clients.
Staff Attorney Duties and Responsibilities:
· Research current state and Federal healthcare regulations.
· Maintain a professional and HIPAA compliant work area.
· Validate the accuracy of the denial and capture/document the detailed CAS code reason(s) and remark codes.
· Based on the detailed finding of the denial, initiate all related and supporting documentation needed for inclusion in the appeal letter.
· Identify if there is the need to include clinical team into the review and appeal process.
· Research payer specific guidelines and contract language to include when applicable for appeal submissions.
· Perform other required duties in a timely, professional, and accurate manner.
· Conducts appropriate account activity on accounts by contacting government agencies, third party payors, and patients/guarantors via phone, e-mail, or online.
· Continue collection activity until account is resolved.
· Responsible for maintaining inventory and that daily productivity standards of assigned accounts are met.
· Identify payor issues and trends and escalate issues to Management.
· Ensure compliance with State and Federal Laws, Regulations for Managed Care and other Third Party Payors.
· Participate with hospital clients on payer phone calls.
Staff Attorney Qualifications:
· Professional writing and verbal communication.
· Strong telephone communication and interpersonal skills
· Ability to operate common computer systems, utilize hospital collection systems and business software
· Strong proficiency Microsoft Office (Word, Excel) skills
· Intermediate understanding of ICD-10, HCPCS/CPT coding and medical terminology
· Has a full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements.
· Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims
· Intermediate understanding of EOB, hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms
Staff Attorney Education/Experience:
· Current J.D., in good standing.
· Strong analytical skills and strong proficiency in Microsoft Office Tools.
· 3-5 years Healthcare experience preferred.
Location: Dallas, TX
Job Type: Full Time, Days
At Praxis Healthcare Solutions, we are continually engaged with the healthcare community and work in partnership to leverage our best processes to drive maximum reimbursement due to facilities. We believe in being the best at what we do. Employee benefits include health insurance, paid holidays, and more. Visit our website at praxishcsolutions.com to learn more about us!
Role: Healthcare Receivables Staff Attorney
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