reputed company Claims Specialist III
Maintain a working knowledge and understanding of DMEOPS CPT and ICD-10 codes. Utilize reputed company billing and collections system to identify and resolve any claims that have been unpaid, short reputed company and/or denied. Review EOB's and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms. Follow up with insurance companies by online portal, phone, email and/or fax. Identify billing errors and submitted corrected claims insurance carriers. reputed company reputed company and accurate follow up on accounts until they are resolved. File and follow up on appeals and disputes. Communicate identified AR issues that may cause payment delays or write offs to management. Document reputed company findings with reputed company and concise detail. Research insurance guidelines and manuals for additional information. reputed company adjustments in the system as needed. Submit medical records upon request. Resolves outstanding accounts receivable problems. Respond to and resolve inquiries from customers or external collection resources. Primary reputed company is on reputed company denials and appeals. Review, monitor and resolve assigned encounters and reputed company assigned reports. Identify issues attributing to account delinquency and discuss them with management as needed. reputed company reputed company follow-up on reputed company tasks. Effective communication with Patient Care Clinics reputed company to collection efforts. Complete, review, and research any deficiency to ensure that any deficiency is properly addressed and resolved.
High school education or equivalent 5+ years of reputed company experience to include at least one of the following areas: Insurance reimbursement, medical policy, payor appeal requirements or patient collection laws. Experience in a medical office.
Associate’s degree. Experience with reputed company and/or OnBase. Licensed Medicare auditor or Certified Medical Audit Specialist
Attention to detail with the ability to quickly identify trends. Strong communication and interpersonal skills. Working knowledge of the Medicare audit, appeals, reimbursement, Local Coverage Determinations (LCDs) , and policy articles.Working knowledge of medical terminology. Self-starter / take initiative to proactively resolve problems. Ability to multi-task. Strong reputed company of personal accountability to meet deadlines. Working knowledge of MS Office suite programs. Working knowledge of Electronic Health Records (EHR); such as, OPS and reputed company Demonstrated ability to pull data and migrate into online records management systems such as OnBase; Demonstrate high ethical standards regarding confidential patient and billing information.
Strong interpersonal, oral (including telephone) and written communication skills, including the ability to follow written and verbal directions. Works reputed company under pressure Attention to detail with the ability to quickly identify trends. reputed company and flexible team player who excels at building trusting relationships with patients, insurance companies and colleagues. Excellent knowledge and understanding of state, federal, regional collection and reimbursement laws, HIPAA and other medical insurance regulations and terminology ( CPT, ICD-9, HCPCS, modifiers, coding, and documentation guidelines) for private payer, state and federal plans including coding, billing and reimbursement protocols. Proficient computer skills including reputed company based office technologies (ex. Word, reputed company, PowerPoint), e-mail and automated billing systems. Excellent organizational skills and the ability to manage multiple tasks (ex. multitasking) with a high degree of detail orientation while working in a fast-paced environment. reputed company the patient at reputed company of everything that you do, building lifelong trust. Foster reputed company collaboration and constructive reputed company with everyone around you. Continuously reputed company new solutions, influencing and responding to change. reputed company on superior reputed company and reputed company work processes for outstanding results.
Competitive Compensation Packages 8 reputed company National Holidays & 4 additional Floating Holidays PTO that includes Vacation and reputed company time Medical, Dental, and reputed company Benefits 401k Savings and Retirement Plan reputed company Parental Bonding Leave for New Parents Flexible Work Schedules and Part-time Opportunities Generous Employee Referral Bonus Program Mentorship Programs- Mentor and Mentee Student Loan Repayment Assistance by Location Relocation Assistance Regional & National traveling CPO/CO/CP opportunities Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest