Follow-up Specialist

Payer Watch is a trusted national leader in healthcare revenue recovery. We employ a two-pronged approach to help hospitals and health systems to achieve better outcomes at a lesser cost. Our Veracity Software and Appeal Masters service assist in preventing and lowering denials and reducing the cost of the claims appeals process.

Job Title: Follow-up Specialist

Job Summary: The Follow-up Specialist is responsible for obtaining payer decisions on appeals/retro-authorization requests filed by the Medical Appeal Advocates.

Job Type: Part‑time, temporary position - This position is located in the Payer Watch corporate office in Towson, Maryland.

• Making high‑volume phone calls and utilizing payer portals to obtain decisions as efficiently as possible.
• Demonstrating a professional demeanor at all times when working with payers and clients alike.
• Demonstrating the ability to prioritize your day to meet business needs.
• Demonstrating superior organizational skills.
• Maintaining a high level of integrity and discretion when handling protected health information (PHI) per HIPAA compliance regulations.
• Processing medical reimbursements for denied commercial, government, and managed care claims as assigned.
• Processing medical records.
• Reviewing Explanation of Benefits (EOB) audit and denial letters and taking appropriate action via verbal or written appeal to challenge low payments and various denials.
• Entering all Payer disputes into the Veracity (Payer Watch proprietary software) daily.
• Completing assigned tasks per departmental policies.
• Contacting payers to request needed documents and following up on pending appeals.
• Demonstrating organizational and time management skills to manage accounts.
• Maintaining a high level of integrity and confidentiality for patient privacy per HIPAA requirements; all information encountered while working in a reimbursement environment is always confidential.
• Performing other duties as assigned.

• Organization:
  Disciplined time management and organizational skills.
• Communication:
  Able to keep supervisor informed of issues and concerns as they arise.
• Quality Commitment:
  Able to do tasks on time and accurately, consistently strives to better one's work, can self‑edit to ensure perfect language and spelling, and can put ongoing learning or process changes into practice.
• Dependability:
  The capacity to accept accountability for one's work product, honor agreements, and voluntarily adhere to corporate policies and procedures.
• Supportive:
  Committed to the organization’s objectives, client preferences, and agreements with customers and coworkers.
• Integrity:
  Upholds privacy, defends patients’ rights to dignity, and ensures individual honesty in all business operations.

• High School or equivalent
• Two years of experience with Microsoft Office

• Associate’s degree in a healthcare or business field (such as healthcare or business administration).
• Knowledge of business office systems.
• Experience in a hospital revenue cycle.
• Experience in data entry.
• Experience working in a fast‑paced, heavy volume work environment.
• Experience working independently.

Follow-up Specialist works at the corporate office located in Towson, Maryland.

All qualified applicants will receive consideration for employment, transfer or promotion without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, or veteran status.

EOE/M/F/D/V