
Medical Claims Processor
1 week ago
Overview of the Billing & Collections Specialist Role:
Key Responsibilities- Coordinate with various departments to post resident accounts and review charges for accuracy, completeness, and consistency.
- Prepare and issue accurate billing statements to payers using electronic systems, monitor submissions daily, and address any denials or requests for additional information (ADRs) within 10 days.
- Follow up on unpaid claims/denials, determine reasons for denial, correct claims, and re-bill when required, while documenting all communications and collection attempts.
- Maintain A/R Aging levels for assigned accounts within company guidelines and notify supervisors of difficult/problem accounts.
- Apply third-party payments daily, including checks, wire transfers, EFT payments, bank deposits, cash, and credit card payments, confirming completeness and accuracy of payment information to residents' accounts.
- Establish good relationships with third-party payers through professional communications and efficiently conduct inquiries and analysis for resolution of discrepancies.
- Two to three years of experience processing skilled nursing medical claims with third parties, including Medicare, Managed Care, and Insurance Companies, with a track record of successful collections.
- One or more years of experience working in a high-volume, short-term rehab environment.
- Knowledge of billing and related software, preferably with experience using similar software.
- Strong communication, interpersonal, and organizational skills.
- Detail orientation and ability to manage multiple priorities.
- Discretionary judgment and ability to work independently and as part of a team.
- Ability to read, write, and speak English proficiently.
We offer a remote working environment that provides flexibility and convenience. You will collaborate with an international team while contributing to our growing business from the comfort of your home.
Some essential tools include a reliable computer, noise-canceling headset, second monitor for enhanced productivity, and stable internet connection. Additionally, you will need a backup internet connection to ensure seamless work completion.
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