Denial Resolution Specialist

Job Title
Denial Resolution Specialist
Job ID
27736595
Work Hybrid
Yes
Location
Austin,  TX 78744 Hybrid
Other Location
Description
For nearly two decades, TenderHeart (formerly known as Longhorn Health Solutions) has been improving the lives of those we serve with high-quality incontinence care management. We start with each individual patient by actively listening to their concerns. Then we ask the right questions to learn more about their challenges. Finally, we develop individualized solutions to meet each patient’s specific needs.
Through our personalized coaching and frequent patient interaction, we decrease the likelihood of adverse patient outcomes, helping patients live happier, confident and more independent lives with a higher level of patient satisfaction. Because of these better outcomes and our value-based model, managed care organizations (MCOs) realize substantial savings while also improving the health of their patients.
Our Vision
TenderHeart seeks to be the national leader of innovative, value-based incontinence services to the broadest possible population of patients and healthcare partners. We believe the more people we serve and the more people we help, as efficiently and effectively as possible, the result will be a stronger healthcare system as a whole.

Our Mission
TenderHeart is committed to delivering exceptional incontinence management through services and products that improve health outcomes and broaden access to care so more patients can live happier, confident, and independent lives.
Our Values
  • Integrity: We are committed to honesty and trust in everything we think, say and do.
  • Compassion: We care, we listen, we respond.
  • Innovation: We create service enhancements that address healthcare challenges.
  • Equality: We respect people, value diversity, and promote inclusivity.
Communication: We are committed to transparency and helpfulness in every interaction

Education, Certificate, and Licensure
High school diploma or general education degree (GED); two years related experience and/or training; or equivalent combination of education and experience.

Requirements
  • Must demonstrate proficient ability and practical knowledge of computers, software, and products applicable to the industry. 
  • Ability to navigate and perform daily work in Word, Excel, Adobe and payor web portals.
  • Prior experience with Brightree or other DME billing software preferred. 
  • Additionally, the employee is expected to demonstrate the ability to quickly acquire knowledge of departmental program structure (Mission, Vision, and Goal Statements) and department policies and procedures.
  • Must be able to work a flexible schedule, as needed, and should have the ability to demonstrate effective time management skills while working independently with minimal supervision.
  • Proficient ability to apply mathematical concepts such as basic algebra to such tasks as calculating figures and amounts, discounts, interest, commissions, proportions, percentages to practical situations.
  • Proficient ability to foster professional working relationships utilizing strong interpersonal and communication skills organization-wide. 
  • Demonstrate the ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, and/or governmental regulations and effectively present and debate any assortment of information relevant to their area of expertise and designated responsibilities and duties with members of the Company and on behalf of the Company when appropriate.

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