Job Description
Collaboratively analyzes, reports on, and provides resolution to work queues. Serves as an interdepartmental liaison for workflow improvements and claim-edit resolutions. Analyzes, verifies, tracks and reports on department related databases and software.
Job Responsibility
Reviews assigned work queues daily to ensure claims generate in a timely manner.
Resolves eligibility related pre-claim edits to decrease insurance denials.
Collaborates with team to identify drivers of volume fluctuations or issues in data quality that would impact reporting (i.e. duplicate records, missing data, etc.)
Communicates regularly with external teams for workflow improvements and edit resolutions.
Maintains trends and tracks various measures to identify possible areas for re-education.
Develops technical and functional specifications based on business requirements and analysis of workflows.
Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
- Bachelor's Degree required, or equivalent combination of education and related experience.
- 1-3 years of relevant experience, required.
This position will be fully remote, Monday-Friday 8am-4pm.
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
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What We Do
Northwell Health is New York’s largest private employer and health care provider, with 23 hospitals and nearly 800 outpatient facilities. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 74,000+ employees – 18,500+ nurses and 14,200+ credentialed physicians, including about 4,500 employed doctors and nearly 3,300 members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu. Interested in a career at Northwell Health?
