Health Insurance Operations Director jobs in Tennessee

About the Role

The purpose of this position is to research and rectify third party healthcare insurance denials, edits, requests for information, and other related correspondence. Support other RCM departments in identifying and analyzing open claims, as well as correct billing errors. The Accounts Receivable Representative must have a thorough knowledge of government, commercial, HMO, PPO, and other types of insurance billing guidelines in multiple states and demonstrate effective judgment when processing all claims.  Given the complexities of the healthcare insurance, it’s vital we have strong, analytical, focus driven individual in this role.

Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing live-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way. 

Responsibilities

• Maintain aged insurance accounts receivable (AR) queues at a reasonable age-base date as defined by leadership
• Responsible for reviewing and appealing denied claims for bundling, medical coding, and contracting related issues
• Responsible for timely follow-up on all appeal submissions
• Will also be involved in processing of corrected claims and assisting with timely turnaround for medical documentation requests
• Providing follow-up and feedback to leadership regarding assignments
• Works and coordinates with other departments throughout the company to ensure smooth and efficient operation in all areas of aged AR
• Works necessary reports to ensure assigned AR is actively worked & maintained

Qualifications

• 3 years of experience in insurance account receivable department, preferably in behavioral health
• Knowledge of payer specific billing requirements
• Highly organized and able to track workflows through various tools
• Strict attention to detail with excellent organizational skills
• Customer service skills to work with insurance companies and teammates within the company
• Maintain a high level of integrity and confidentiality of medical information#LI-HY
• Able to work a hybrid schedule of 4 days/week in our Nashville office and located within 75 minutes' commuting distance of the office

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Note: We are not currently considering applicants in CA, CO, NY, and WA for this position.  #LI-HYBRID