Job Title: Claim Follow-Up Specialist

Company: Reveloop Revenue Cycle Management

Location: Kampala

About Reveloop:

Reveloop is a renowned revenue cycle management company specializing in providing boutique behavioral health billing solutions. Our core values of honesty, honor, humility, hard work, collaboration, and unceasing improvement guide our work. With a vision to become the leading boutique behavioral health billing solution provider, our mission is to increase revenue through unmistakable quality and spectacular revenue cycle management.

Job Summary:

As a Claim Follow-Up Specialist at Reveloop, you will play a crucial role in ensuring the resolution of outstanding claims for our behavioral health billing clients. Your exceptional communication skills, tenacity, and attention to detail will contribute to our clients’ financial success. This position requires a strong understanding of revenue cycle management practices, exceptional problem-solving abilities, and the ability to navigate payer systems.

Responsibilities:

– Conduct timely and persistent follow-up on unpaid or denied claims with insurance companies, payers, and other relevant parties.
– Analyze claim denials and rejections to identify root causes and develop appropriate action plans for claim resolution.
– Collaborate with internal teams to gather necessary information, documentation, or appeals required for successful claim resolution.
– Maintain accurate and detailed records of claim follow-up activities, interactions, and resolutions in internal systems.
– Monitor claim aging reports and prioritize follow-up activities based on urgency and potential financial impact.
– Communicate effectively and professionally with insurance companies, payers, and other stakeholders to obtain claim status updates, payment information, and clarification on outstanding issues.
– Research and stay up to date on payer policies, coding guidelines, and industry best practices related to claim follow-up and resolution.
– Escalate complex or unresolved claim issues to appropriate internal teams for further assistance or intervention.
– Provide exceptional customer service to internal and external stakeholders, addressing inquiries and resolving issues promptly and professionally.
– Collaborate with cross-functional teams to identify trends or patterns in claim denials and develop strategies to minimize future issues.

Requirements:

– Bachelor’s degree required
– Proficiency in using medical billing software, claim management systems, and electronic health records (EHR) platforms.
– Strong understanding of behavioral health coding and billing guidelines (e.g., CPT, HCPCS, ICD-10) and their application to claim follow-up activities.
– Familiarity with insurance payers’ claim processing systems, billing requirements, regulations, and policies.
– Excellent communication skills, both verbal and written, with the ability to interact professionally and persuasively with diverse stakeholders.
– Exceptional problem-solving and analytical abilities to identify and resolve claim issues effectively.
– Strong organizational skills and the ability to manage multiple tasks simultaneously while meeting deadlines.
– Proficient in navigating payer websites, portals, and other electronic resources for claim follow-up purposes.
– Demonstrated ability to work independently and collaboratively within a team environment.
– Commitment to maintaining confidentiality of sensitive information and adhering to HIPAA regulations.

Join the Reveloop Team:

If you are seeking a challenging and rewarding opportunity to contribute to the growth and success of a leading boutique behavioral health billing solution provider, Reveloop is the place for you. We offer a supportive work environment, competitive compensation, and opportunities for professional development. Join our team and be part of our mission to deliver unmistakable quality and spectacular revenue cycle management.

To apply, please submit your resume and a cover letter outlining your relevant experience and why you are interested in joining Reveloop. We look forward to reviewing your application and getting to know you better.

Note: Only shortlisted candidates will be contacted for further evaluation. Please do not apply for every job posting – one application will be considered for all openings.