(Remote Work) Edit Research Specialist – FinThrive

Job Overview

• Job Title Edit Research Specialist
• Hiring Organization FinThrive
• Company Website https://finthrive.com/
• Remote Locations Worldwide
• Job Type  Remote, Full-Time

FinThrive is advancing the healthcare economy. We rethink revenue management to pave the way for a healthcare system that ensures every transaction and patient experience is addressed holistically. We’re making breakthroughs in technology—developing award-winning revenue management solutions that adapt with healthcare professionals, freeing providers and payers from complexity and inefficiency, so they can focus on doing their best work. Our end-to-end revenue management platform delivers a smarter, smoother revenue experience that increases revenue, reduces costs, expands cash collections, and ensures regulatory compliance across the entire revenue cycle continuum. We’ve delivered over $8.8 billion in net revenue and cash to more than 3,245 customers worldwide. When healthcare finance becomes effortless, the boundaries of what’s possible in healthcare expand. For more information on our new vision for healthcare revenue management, visit FinThrive.com

Impact you will make

The Edit Research Specialist provides support and guidance to Associate support team members in several key areas like simple to medium rule writing or maintenance, provide excellent quality assurance, ensure client facing documentation and training materials are created to assist customers as needed. As a Specialist, they accept primary responsibility for a select group of small to medium sized clients in states supported by a Senior Specialist, and supplementing the Team Lead, Manager, Sr. Manager, Director or Sr. Director role. They will also assist in monitoring for payer changes in those states to support the Senior Specialist in setting development priorities for their states. The Specialist will provide support to the other team members for payer edit research as needed for the maintenance of the approximately 20K rules in the edit library.

Job Responsibilities

• Maintain/expand personal knowledge of the healthcare industry, particularly in the area of billing compliance
• Develop at least one SPL per quarter to provide guidance and support to other team members or departments
• Manage SalesForce Case queues and provide clear and timely client facing communication in cases
• Ensure all quarterly and annual Medicare, TRICARE, Medicaid, Blue Cross, Workers’ Comp, and Commercial payer updates are appropriately completed within acceptable time frames
• Ensure testing processes are followed and support client facing communication documents are correct (i.e. Edit Advisory). Provide peer testing as needed to maintain quality assurance
• Provide for training and mentoring of Edit Research Specialists & Associate Specialists, and lead the Specialists training activities by example
• Assist with Payer transitions and provide representation at meetings
• Seek opportunities for process improvements, and actively participate in team LEAN initiatives. Suggest at least one improvement opportunity per quarter and provide recommendations for consideration
• Maintain acceptable workload backlogs and strive for reduced TAT in an effort to meet goals for turn-around time for SalesForce Cases
• Research, document, development, maintenance, and testing of payer rules for claims management system as well as testing of all custom edit changes to the customer sites
• Provide liaison support between customers and payers with respect to regulatory billing compliance to safeguard FinThrive and their customers from HIPAA transaction set violations
• Provide excellent client support to assigned enterprise clients and any other assigned customers
• Mentor associate level staff
• Complete special projects as assigned
• Successfully engage in multiple initiatives simultaneously
• Continually seek opportunities to increase customer satisfaction and strengthen client relationships

Internal Responsibilities:

• Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time Adheres to all applicable laws and regulations and the company’s governance/compliance program
• Responsible for reporting violations of the company’s policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company’s Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts
• Becomes knowledgeable of internal control responsibilities through training and instruction. Responsible and accountable for internal control performance within their area of responsibility. Participates in the internal controls self-assessment process
• Ensures concerns with internal control design or performance and process changes that impact internal control execution are communicated to management

Job Requirements

• 1+ years’ experience in healthcare industry and/or a degree in a related field
• Problem solving and multi-tasking skills
• Flexibility combined with the ability to thrive in an environment where direction and initiatives change frequently
• Intermediate technical writing aptitude, analytical skills and detail orientation
• Intermediate written and verbal communication skills
• Professional presentation combined with a customer service attitude
• Demonstrated ability to work in a team environment that requires quick turnaround and quality output
• Solid knowledge of all MS Office Products
• Understands hospital and physician client relations and internal client processes and is capable of defining processes that will benefit both vendor and client
• Working knowledge of Government Programs, commercial, workers compensation compliance rules
• Capable of working independently and providing support to assigned clients
• Possesses initiative, analytical skills, with emphasis on problem solving capabilities & excellent communication skills
• Problem solving, multi-tasking and strong analytical skills required

What we would like to see

• 1+ years related Institutional or Professional billing or coding compliance preferred

Employee Benefits

Our people make us great. We know that our colleagues are the most integral part of our story.

We offer a flexible, work-from-anywhere environment -coming together across time zones, countries, home offices and computer screens. Our valued team members work across the U.S., Canada, India and beyond.

We encourage you to take time away from work –whenever you need it. Our flexible time off lets you make time for what matters most. We want you to travel, refresh, spend time with family and friends, and give back to your communities.

We’re big on professional development. Through training and education, we help you develop the skills you need to excel in your role and beyond.

We’re proud of our award-winning culture. We’ve been certified as a “Great Place to Work” since 2017. Our goal is to engender a culture based on diversity, inclusion and respect—a culture where your voice is valued—and you always have a seat at the decision-making table.

FinThrive Perks

• Fully remote working environment
• Flexible time off (FTO)
• Professional development opportunities
• 12 Weeks of paid parental leave
• In-person and virtual company retreats
• 5-days of paid volunteer hours at an approved 501(c)(3) Organization
• Company lump-sum contribution to HSA-eligible medical enrollees
• 401k Eligible upon date of hire—up to 3% company match
• Exclusive discounts from your favorite brands via PerkSpot

How To Apply

Click “Apply” below to fill in the application form!