Job Summary: You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services. This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.In your role you will review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review. Communicates with third party payors to resolve discrepancies prior to billing. Accurately and concisely documents all communications and action taken on the account in accordance with policies and procedures. The Prebill Denials Analyst will escalate medical review request and/or denial activities to the Prebill Denials Nurse.**Responsibilities**:- Work prebill accounts imported into the PDU Tool efficiently and effectively on a daily basis to resolve accounts with "no auth numbers and ALOS vs. authorized days variances- Work assigned accounts in eRequest to resolve outstanding issues- Report insurance denial trends identified during daily operational assignments- Identify problem accounts and escalate as appropriate- Document actions taken on the account clearly and concisely- Contacting the facilities, physicians' offices and/or insurance companies to resolve denials/appeals- Adhere to time and attendance policies- Adhere to all policies and procedures, including phone and internet usage, break utilization, etc.- Participate in ongoing education and training as needed- Establish and maintain relationships with all customers- Seeks assistance from immediate supervisor when in situations which are unclear or ambiguous- Adheres to established policy and procedure and escalates issues through the established Chain of Command- Demonstrates commitment to teamwork and cooperation- Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"Skills and Experience:- English - Spanish Language (Oral and writing 85% or higher), (C1 or above).- Must have a high school diploma or in progress to complete high school.- At least 1 year of experience in Customer Service positions.- This job adjusts to the Eastern Time Zone and follows a US holiday schedule. (May include working 2-3 sundays per year)- Strong customer service skills- Excellent communication skills- Ability to work independently and collaboratively- Attention to detail- Comfortable multitasking in a high volume/high demand environment- Good presentation and a polite, tactful, and friendly character.About Auxis:Auxis prioritizes employee growth and development to help you advance your career. Auxis' culture empowers you to be your best in the interest of a common team goal. We are constantly striving to improve our culture and environment and have invested in tools to continue to have better visualization of the pulse of our organization.- Benefits_- Health benefits including medical, vision, and dental.- Transportation subsidy- Asociacion Solidarista- Training and development programs- Employee recognition program- Paid time off and family paid leave- Paid day off for your birthday!
