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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced knowledge of hospital billing processes, particularly with Medicare payer rules and UB04 Facility Pricing. Proficient in analyzing contracts and managing insurance follow-ups while ensuring compliance with relevant regulations.
Highest-signal resume keywords
Hospital Billing ExperienceMedicare Payer KnowledgeUB04 Follow-Up AnalysisAdvanced MS Excel SkillsInsurance Denial Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Hospital BillingContract AnalysisInsurance Follow-UpUB04 Facility PricingMedicare Direct Data EntryRevenue Cycle ManagementAnalytical SkillsDetail-OrientedCompliance KnowledgeProblem Solving
Soft Skills
OrganizedMentoringIntegrityCollaborationCommunication
Tools & Technologies
Rubixis AR Follow Up SoftwareEPICParagonZirmedHIT Systems
Industry Keywords
HIPAA ComplianceFCRAGLBABilling RegulationsReimbursement Procedures
About the role
Key responsibilities & impact- Learn and understand the Rubixis platform and available resources
- Work assigned accounts from start to finish successfully and in a timely manner
- Call healthcare insurance companies, affiliates, and providers to resolve contract or payment issues
- Analyze contract, billing, cash costing, pricing, and collections in compliance with billing regulations, policies, and procedures
- Investigate insurance payments that deviate from expected payment
- Collaborate with leadership and team members to confirm, challenge, or provide trends and solutions
- Manage moderately complicated insurance denials and underpayments using Rubixis AR Follow Up software
- Mentor Rep I and Rep II associates
- Demonstrate integrity and ethics in daily tasks and decision-making
- Support FinThrive's compliance program and participate in required training
Requirements
What you’ll need- 5+ years Hospital Billing with follow up experience
- Advanced knowledge of all payer types
- Knowledge of Medicare payer rules and processes, including interpreting denial reasons, submitting appeals, and accessing Medicare portals
- Ability to use Medicare Direct Data Entry (DDE) to submit claim corrections, adjustments, and inquiries
- Detailed understanding of insurance follow-up for non-paid, denied, under-paid, and rejected claims
- Experience in UB04 Facility Pricing and Reimbursement variance
- Good understanding of revenue cycle
- Basic understanding of HIT systems such as EPIC, Paragon, Zirmed, or other billing systems
- Problem solving and superior analytical skills
- Organized and detail-oriented aptitude
- Bachelor's or associate degree
- 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of pricing and reimbursement variances
- 2+ years of experience with Medicare processes and systems
- Detailed knowledge of Facility Reimbursement contracts, fee schedules, and reimbursement procedures
- Advanced MS Excel skills
- Ability to comply with HIPAA, FCRA, GLBA, and other applicable laws and policies
- Ability to handle patient information in a HIPAA-compliant manner and maintain confidentiality
Benefits
Comp & perks- FinThrive perks and benefits; specific current offerings are provided at finthrive.com/careers-benefits
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
- Equal Opportunity Employer protections and applicable employment-law compliance