Medical Accounts Receivable Representative

About Culina Health

Culina Health is a personalized nutrition platform powered by registered dietitians to help you prioritize the way you want to live. We make insurance-covered nutrition care accessible and easier to understand so that you can fuel a satisfying and well-balanced life. We are based in Hoboken but employ many remote employees. Culina is a flourishing early-stage start-up with enormous opportunities for aspirational, hard-working professionals. Our growth is important, our employees' health is important, and so is our ability to help bring Clinical Nutrition to every person that needs it.

At Culina Health we are working on a variety of software environments and platforms, including graphical user interfaces for embedded systems, desktop applications, mobile apps, and web-based applications. Our work is equally focused on incremental improvements to existing solutions and the ground up design of innovative products and services that are new to our clients.

Job Description

Responsibilities & Key Initiatives

• 
  This is a patient facing role; ability to effectively communicate with patients, providers and leadership
• Checking claim status
• Rectifying denials
  • Adjusting nuances of any demographic errors
• Coding knowledge
  • Diagnosis: Medical versus Preventative
  • ICD 10 / ICD 11

Qualifications

• Proactive self-starter with medical billing (hospital / physician practice) background
• Minimum 1 year experience
• Follow up claims experience
• Well versed in insurance and different carriers
  • AllScripts & PayerPath
  • insurance follow up
  • Denials knowledge / denial codes
  • EDI
    • Payerpath
      • 835 & 837 understanding (answer is: 835 is payment remit, 837 is the actual denial that comes back to payerpath)
    • Understands "The Blues" (BCBC: NY, NJ, Mass, Fla, Anthem)
      • Needs to understand the registration process as we have multiple offices, multiple NPIs, and payor identifiers.
      • Payor codes
    • Experience in self pay and insurance follow up

Here at Culina Health, we live by our core values that People Come First, Everything is Rooted in Science, Compassion Across Care and Operations, and Accessibility and we welcome all.

People come first is evident in how we treat our colleagues and peers and through the meaningful relationships we develop with our patients. Everything rooted in science is shown through the incredible work our registered dietitians do and through the results our patients produce. Compassion across care and operations doesn't just reflect in our interpersonal relationships but also how we live our lives, think about nutrition and operate the day to day of a flourishing start-up. Culina Health's mission is to make nutrition accessible & sustainable for everyone.

Culina Health is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.