Medical Claims Insurance Specialist - Remote

๐ŸŒ Remote, USA ๐Ÿš€ Full-time ๐Ÿ• Posted Recently

Job Description

Possess a thorough working knowledge of the revenue cycle management process. Responsible for the research and resolution of aging account receivables to that are either unpaid or incorrectly paid. Demonstrate the companyโ€™s core values of respect, honesty, integrity, diversity, inclusion, and safety.

  • Analyze, audit and resolve claims outstanding, denied, or incorrectly paid
  • Review and respond to payer correspondence.
  • Submit appeals as needed for denied claims.
  • Contact insurance companies and navigate payer websites in order to secure and expedite insurance payments.
  • Resolves patient billing inquiries.
  • Document in detail all actions taken in accounts receivable system.
  • Meet productivity expectations as outlined by supervisor.
  • Recognize, document and notify Team Lead of trends resulting in nonpayment or incorrectly paid claims.
  • Answer and resolve inbound calls from insurance carriers.
  • Participate in process improvement initiatives as needed.
  • Keep current with Medicare and other third party administrators regulations and procedures.
  • Manage any special projects requested by supervisor or team lead.
  • Must be able to perform the essential functions of this position with or without reasonable accommodation.

Minimum Position Qualifications:

  • High school diploma
  • 1+ year of insurance follow-up including working knowledge of the appeals resolution process
  • Strong written, and oral communication skills
  • Analytical and problem solving capabilities with close attention to detail.
  • Excellent organizational and follow-up skills
  • Thorough working knowledge of revenue cycle management including medical terminology,ICD-9, ICD-10, CPT-4 coding, Medicare reimbursement guidelines, billing and collection practices
  • Ability to read and interpret EOB's
  • Highly self-motivated, with ability to work independently and meet deadlines
  • Ability to remain flexible during times of change and adjusts promptly and effectively
  • Must be able to learn, understand, and apply new technologies

Originally posted on Himalayas

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