Collections Specialist (Revenue Cycle)

Claims And Denials Resolution Specialist

Your role : Working with various commercial insurance payers to resolve claims and denials. Escalating payor issue trends for leadership consideration along with possible solutions. Providing daily follow-up on insurance correspondence to ensure claim payments are made in a timely manner. Developing and maintaining updates for any problematic payers and assisting in identifying, evaluating and developing systems / procedures to address issues. Determining patient eligibility along with basic benefit verification (qualifying diagnoses, prior testing and authorization requirements) and reading eligibility of benefits, to determine claim processing by insurance carriers.

You're the right fit if : You've acquired 2+ years of experience in Revenue Cycle Management, specifically within Collections or Reimbursement Services. Your skills include : Experience with denial management, claim follow up, overturning denials and identifying payer issue trends. Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans. You have the ability to navigate through various systems to pull information. Experience with Soarian is a plus. You have a high school diploma or GED (required). You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position. You're a strong verbal communicator with both internal / external partners.

How we work together : We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations. This is an office role.

About Philips : We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.

Philips Transparency Details : The pay range for this position in Malvern, PA and Chicago, IL is $23.00 to $37.00 hourly. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge / skills, experience, business needs, geographical location, and internal equity. In addition, other compensation, such as an annual incentive bonus, sales commission or long-term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here. At Philips, it is not typical for an individual to be hired at or near the top end of the range for their role and compensation decisions are dependent upon the facts and circumstances of each case.

Additional Information : US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Malvern, PA or Chicago, IL.

It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to race, color, ethnicity, religion, gender, pregnancy / childbirth, age, national origin, sexual orientation, gender identity or expression, disability or perceived disability, genetic information, citizenship, veteran or military status or a person's relationship or association with a protected veteran, including spouses and other family members, marital or domestic partner status, or any other category protected by federal, state and / or local laws. As an equal opportunity employer, Philips is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance. Equal Employment and Opportunity Employer / Disabled / Veteran