Overview
We are looking specifically for an Out-of-Network Negotiator who eats, sleeps, and breathes the No Surprises Act for Surgery specialty.
The Role: You will be a point person for all out-of-network revenue. Your day-to-day will involve high-level negotiations with insurance companies, managing the "No Surprises" negotiation process, and winning appeals through meticulous clinical reviews.
What You Must Bring:
• Negotiation Grit: You know how to talk to payers and get claims paid at higher than "median" rates.
• NSA Expertise: You understand how to handle out-of-network claims without triggering balance-billing violations.
• Detail Mastery: You can review complex medical records and terminology to find the "hook" for a successful appeal.
• Team Mindset: You are an independent contractor who loves working with a remote team of other experts.
Technical Skills: Professional experience with OON appeals, negotiation portals, and high-level medical revenue cycle management.
Duties
• Process and record incoming denials to review and appeal.
• Manage accounts receivable aging reports to negotiate appeals for no surprise billing with insurance company for review.
• Review patient accounts for discrepancies and resolve issues as needed.
• Collaborate with the medical billing team to ensure proper coding of services using DRG, CPT, ICD-9, and ICD-10 coding systems.
Requirements
• Proven experience in medical billing, collections, or a similar role within a medical office setting.
• Strong knowledge of medical terminology and coding practices (DRG, CPT, ICD-9, ICD-10).
• Familiarity with EMR and EHR systems is highly desirable.
• Excellent attention to detail with strong organizational skills.
• Ability to work independently while managing multiple tasks effectively.
• Strong communication skills for interacting with patients and team members.
• Availability to work a day shift, Monday through Friday.
Compensation & Hiring Process:
• Pay: Starting from $15.00 per hour.
• Job Type: Part-time, Independent contractor.
• Trial Period: A two-week paid trial period will be conducted to assess knowledge and skills.
Job Types: Part-time, Contract
Pay: From $15.00 per hour
Benefits:
• Flexible schedule
Work Location: Remote