Claims Specialist, RCM - In-Office

About the role

The Claims Specialist will join the revenue cycle department and be responsible for reviewing, correcting, and preparing claims for accurate and timely submission to insurance carriers. As part of the Coding and Charge Entry team, this role identifies and resolves claim edits and errors before submission to help ensure clean claims are filed the first time correctly.

Responsibilities

• Help develop & maintain a corporate culture that supports the mission and values of Mayfield Clinic
• Review and make needed corrections to claims in the assigned work queues
• Submit electronic and hard copy claims in an accurate and timely manner
• Make all necessary corrections to claims that do not pass the billing edits and payer requirements
• Monitor the effectiveness of claims edits and raise issues/suggestions to leadership
• Prioritize claims based on aging and outstanding dollar amounts or as directed by management. Make necessary adjustments as appropriately required by plan reimbursement and company policy
• Absorb and respond to payer inquiries and resolve questions and requests for information in a timely and professional manner to ensure resolution and reimbursement
• Update data in the practice management system as required
• Contribute to the team environment by performing other duties as assigned

Requirements

High School Diploma required
Two years of experience in healthcare administration/revenue cycle
CRCR/CPC or relevant certification preferred

Qualifications

• Excellent customer service
• Ability to convey empathy
• Strong problem-solving, problem-prevention, and decision-making skills
• Ability to manage and prioritize multiple tasks in a fast-paced environment
• Excellent oral and written communication skills
• Ability to maintain composure and restore calm in a stressful situation
• Uses good judgment and diplomacy when dealing with others
• Desire and ability to work in a team environment
• Computer proficient with the ability to learn multiple software applications
• Works with minimal supervision

Skills

• Uses good judgment and diplomacy when dealing with others
• Desire and ability to work in a team environment
• Computer proficient with the ability to learn multiple software applications
• Works with minimal supervision

Benefits

Mayfield Clinic Mission: To provide the best neurological care for our patients through: Superior clinical outcomes Compassionate patient care Education and research Innovation

Pay

This is a full-time, in-office position based in our Norwood, Ohio, location.

Schedule

Associates are expected to work onsite during scheduled business hours. This position is not eligible for remote or hybrid work. Candidates should reside within commuting distance of Norwood, OH, or independently relocate before their start date.