Title : Insurance Payer Specialist
Location : Sunnyvale, CA
Salary : $60,000 - $85,000 / year Base Salary + Bonus
We are a privately owned company, founded in 2010, launched the world's first Bluetooth-connected blood pressure monitor that works with iOS devices.
Through more than a decade of development, by integrating its FDA-approved, award-winning consumer medical devices and remote patient monitoring platform, we established a digital health ecosystem for healthcare providers to manage chronic diseases remotely.
We are seeking an Insurance Payer Specialist to provide health insurance payer analysis in relation to medical billing and reimbursement functions, manage complex payer and industry changes that impact our revenue cycle for our remote patient monitoring and care management services.
What You Will Be Doing
1) Perform health insurance payer analysis respect to medical billing and reimbursement functions
2) Annually updates insurance payment rates for each CPT / HCPCS code
3) Explore and update key healthcare industry payers trends at both macro and micro levels
4) Define payer policies, coverages, pay rates for procedures
5) Follow and adhere to all regulations and guidelines set by Medicare, State programs, and HMO / PPO, etc
6) Engage in end-to-end revenue cycle management process, including Eligibility verification, Authorization, charge entry, claim submission (including 837's and 1500 forms), payment posting, and accounts receivable management and extract reports from billing software
7) Engage in follow-ups with insurance companies and medical groups to address denials and payer coverage issues
8) Generate reimbursements and analyze the revenue data to report trends related to errors & denials
9) Ensure compliance with healthcare billing regulations and stay current with changes in billing and coding guidelines to ensure accurate and compliant billing practices
10) Maintain compliance with HIPAA(Health Insurance Portability and Accountability Act of 1996)
What You Need for this Position
1) Bachelor's degree in cin accounting, healthcare admin, business, or related field
2) 5+ years in healthcare related field
3) Knowledgeable of CPT / ICD-10 / HCPCS codes and EHR systems
4) Proficient in medical terminology and insurance plans
5) Strong computer literacy with using Google Docs, Sheets, Slides and Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel)
6) Experience with process improvement, quality control, data analysis and / or reporting
What's In It for You
1) Competitive Salary
2) Medical / Dental / Vision / Life Coverage
3) 401k Plan w / Company Match
4) Vacation Paid Leave and PTO
5) Bi-Annual Performance Bonus Structure
Benefits
Applicants must be authorized to work in the U.S.
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