Medical Claims Auditor / Healthcare Advocate

Come be a part of a rapidly growing and dynamic healthcare company!

inAssist is one of the nation's leading providers of Healthcare Management Solutions. Our team of Healthcare Advocates, Medical Claims Auditors, Medical Claim / Billing Data Entry Specialists, along with extensive analytics and customized technology provide best in class healthcare management and peace of mind. Driven by our commitment to our clients, we pride ourselves in our ability to ensure they receive the best service possible.

Job Role:

· Review patient medical bills, correspondence and Explanation of Benefits (EOBs) for accuracy. Enter / upload documents and details of EOBs into our proprietary system

· Communicate with insurance Companies and providers to address any issues that are identified (e.g., appeal incorrectly denied claims, coordinate with providers to fix billing errors, negotiate with providers in the case of inappropriate billing)

· Communicate with clients via phone and email – respond to client requests in a timely, professional and empathetic manner, strive to surpass expectations to ensure concerns are addressed and medical bills and associated paperwork is no longer a worry

· Provide client support with benefit/health insurance questions and locating providers

· Utilize reporting functions within system to identify inaccuracies, errors or inconsistencies within claims

· Summarize findings, make corrections and/or recommendations to resolve claims/billing issues. Communicate findings to correct internal department for corrections when necessary

Job Requirements:

A background in medical billing or insurance claims administration (Medical Billing and Coding Specialists, and/or Health Insurance Claims Administrators strongly preferred)

• 3+ years experience in medical Billing and A/R follow up or Guild experience preferred
• Extensive Explanation of Benefits (EOB) knowledge
• Understanding of general coordination of benefit (COB) rules, Guild experience, benefit analysis
• Experience with out of network claims a plus
• Knowledge of eligibility requirements and enrollment
• Experience in overturning claim denials - ranging from simple solutions such as coding correction (modifiers) to more complex, involving submission of appeals and grievances
• The desire to be part of a team of professionals that have fun while really making a difference for our clients
• Proficient with Microsoft Office
• Ability to think outside the box with excellent time and deadline management skills
• Ability to prioritize many coexisting projects
• Problem solving skills that persist to a solution
• Excellent organizational and scheduling skills are crucial
• Ability to multi-task, while working with a sense of urgency
• Self motivated / Self Starter
• Reliable
• Excellent verbal and written communication skills - must be able to communicate effectively with clients, insurance companies, and providers both in writing and over the phone
• Possess strong interpersonal skills and superior customer service skills - maintain a compassionate, yet professional approach always
• Knowledge of CPT/ ICD- 9 and 10 is required. Medical Billing and / or Coding Certificate a plus

Benefits you will enjoy when you join our team:

• Extensive paid training
• A supportive team environment
• Advancement opportunities
• Benefits, including medical, dental, vision, 401K and life insurance.
• Generous PTO and paid Holidays
• Part time and full time opportunities available.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Medical Claims/billing: 3 years (Preferred)
• reading/understanding Explanation of Benefits: 3 years (Preferred)
• Guild insurance: 1 year (Preferred)

Work Location: In person