Who are we?

As an innovative primary care provider, Avance Care is in the business of improving the standard of healthcare. By offering convenient, accessible, cost-effective healthcare services, we keep our patients at the center!

Why us?

• Our hybrid, mostly remote schedule offers more flexibility throughout the week.
• We offer a comprehensive benefits package available on the first of the month following 30 days of employment.
• Our company-wide growth means consistent opportunities for advancement.

Core Responsibilities

• Maintain confidentiality of patient information per HIPAA laws
• Oversee the Claim Cycle to resolution, ensuring efficiency and accuracy
• Review and resolve front end rejections in Clearinghouse and Billing Software
• Research, address, and resolve all payer claim denials, account discrepancies and payment variances
• Contact appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution. Re-file or bill to patient as appropriate
• Address and resolve incoming phone calls from insurance companies regarding claim denials or processing
• Research and collect information to submit appeals. Follow-up on all billing related appeals
• Provide Medical Records and supporting documents to various insurance company websites to assist with claim resolutions
• Review, file, print HCFA’s and mail corrected paper claims or secondary claims to insurance companies as appropriate
• Review, sort and resolve daily correspondence (mail, fax, etc.)
• Process insurance refunds and reconcile patient accounts in billing system
• Record and analyze denial trends and suggest front-end resolutions to leaderships such as claims rules engine updates to avoid further denials for a specific reason
• Provide patient support through the Avance Care email. Communicate with patients and/or family members regarding account status
• Process patient payments over the phone, post payments to appropriate accounts and provide receipts
• Collaborate with Payments/Collections Team and Outsource Call Center associates regarding patient inquiries
• Collaborate with Coding Team regarding discrepancies for claim denials
• Aid clinic locations regarding account, insurance, or billing process inquiries
• Respond to all actions and telephone encounters within 72 hours
• Return all voicemails and emails within 24 hours
• Complete audit for AR work performed by Outsource associates
• Update individual and A/R Production spreadsheet within HealthWare daily
• Accomplish all tasks as assigned or become necessary
• Run Accounts Receivable Reports through reporting tools

Qualifications

• High School Diploma, required
• Post-secondary Certificates in related field, preferred
• 1-2 years related experience, preferred
• Bilingual in English/Spanish required

What are we looking for?

• Knowledge of insurance practices
• Excellent verbal and written communication
• Confidentiality
• Strong computer skills
• General Math Skills
• Strong attention to detail
• Payer policy research and analysis skills, preferred
• Denial analysis and trending skills, preferred
• Knowledge of the HCFA 1500 claim form, preferred

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• Monday to Friday

Ability to Relocate:

• Durham, NC 27707: Relocate before starting work (Required)

Work Location: In person