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About Us:Join our dynamic team dedicated to excellence in healthcare administration! We are currently seeking six enthusiastic individuals to join us as Claims Processing Specialists. If you are passionate about making a difference in the healthcare industry, have a keen eye for detail, and thrive in a collaborative environment, this opportunity is for you.
MAJOR DUTIES & RESPONSIBILITIES:
Responsible for correcting, completing, and processing claims for all payer codes;
Analyze and interpret that claims are accurately sent to insurance companies;
Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports;
Process appeals online or via paper submission; Assist with billing audit related information; Process refund requests;
Attend provider meetings/ workshops when needed;
Communicate with billing and credentialing coordinator to identify and resolve audit review isues;
Process billing calls and questions from patients and third party carriers;
Answer/respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staffs, Managed Care Organization, etc.;
Communicate daily with internal and external customers via phone calls and written communications;
Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor;
Research, record findings, and communicates effectively with Manager to achieve optimum performance;
Pursue and participate in education to remain current with changes in the Healthcare industry;
Maintain patient confidence and protects medical office operations by keeping patient information confidential;
Contribute to team effort by accomplishing related results as needed;
Promote effective working relations and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives;
Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment
