Billing Payer Response Analyst (back office and calls)

Our client, an important company specialized in consulting and outsourcing (customer services), located in Flores of Heredia, requires Billing Payer Response Analyst. This position is responsible for reviewing and correcting claims denied by the payer. This includes identifying trends and requesting updates to system processes and master files to reduce future payer denials. (90% back office / 10% calls).

DUTIES

• Timely review and resolution of payer claim denials, including, but not limited to, resubmitting claims and updating the payer ID on the account.
• Documentation of the root cause of denial by the payer for trend analysis and staff education.
• Request process modifications and/or system edits to eliminate or reduce future claim denials by the payer.
• Trend analysis of payer denials to present to the Billing Manager and distribute to affected departments.
• Practice and adhere to the Code of Conduct philosophy and the Mission and Values ​​Statement.
• Other duties as assigned.

REQUIREMENTS

• English Spanish Language (Oral and writing 85% or higher), (B2+ or above).
• Must have a high school diploma.
• 1 year of experience in Customer Service or back-office positions.
• The resource will adjust its local schedule with the resources supporting this position during Daylight Savings time changes in the Eastern Time Zone.
• A genuine interest in working with and helping customers.
• Must possess excellent communication skills and involvement.
• Good presentation and a polite, tactful, and friendly character.
• Healthcare experience is a plus.
• Working hours Monday to Friday in a range from 7am to 6pm.