HealthCare Claims Clerk (On-site)

Job Responsibilities

• Reviews the claims billing processes, looking for ways to achieve positive financial outcomes
• Identify problems and find solutions to claim rejections, denials, and underpayments
• Inform management of trends in billing issues related to internal processes, clearinghouse claims processing, and third-party requirements
• Research denials and billing requirements of third-party carriers utilizing EOBs, provider manuals, web portals, and phone contact
• Adjudicate claims issues by preparing and submitting corrected claims and appeals
• Recommend claims for write-off when billing requirements are not met
• Effectively communicate by phone, email, and in-person with third-party payers and internal staff to resolve billing issues and establish positive relationships
• Accurately update and notate accounts receivable system, collections notepad, and customer accounts
• Remain updated on company policies and procedures and third-party payer guidelines, bulletins, and billing requirements
• Ensure appropriate follow-up and timely completion of assignments
• Completes special projects as assigned, supporting team and organizational objectives and continuous improvement initiatives

Qualifications

• High school diploma or equivalent
• 2 years in a medical billing or collections role or similar experience
• Medical billing and coding certification from accredited program preferred
• Familiarity with various medical insurance payer guidelines/billing requirements preferred
• Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams)
• Experience working in Excel
• Strong written and verbal communication abilities
• Proven ability to research and solve problems
• Strong organizational skills, detail oriented, thorough, accurate, with the ability to manage multiple priorities and respond to changing business needs

Pay & Benefits

• $19.50/hour
• Medical, Dental, and Vision (Available first day of employment)
• 401(k) with Company Match
• Sick and Vacation Days
• Flexible Spending Account
• Life & Disability Insurance
• Education Assistance