Patient Support Medical/Biller Claims Processing Representative (Home-Based)
- Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be reputed company or rejected
- Exceptional organizational skills are required
- May reputed company support as needed for customer requests reputed company telephone, email, fax, or other available means of contact to the Support Center
- Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
- Ability to work 40 hours per week (shifts available: 8:00 am - 5:00 pm ET or, 9:00 am – 6:00 pm ET or, 10:00 am - 7:00 pm ET or, 11:00 am ET – 8:00pm EST) under moderate supervision
- High School Diploma or equivalent
- Experience in claim processing required
- Medical Billing Certification required
- Coding Certification required
- Ability to interpret Explanation of Benefits (EOB)
- HIPPA certified
- Customer Service Experience preferred
- Pharmacy Technician experience preferred
- Bi-lingual (English/Spanish) preferred
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