Medical Claims Specialist - Hybrid

WHO WE ARE

AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. Our mission is to modernize and digitize the delivery of healthcare and improve countless lives along the way. We combine the power of big data technology and people to enable easier frontline decisions about complex problems. AC3 offers its employees an exciting, fast-paced, and challenging work environment. To learn more about AC3, visit us at www.ac3health.com.

POSITION SUMMARY

This position is responsible for gathering and processing the information required to complete the medical insurance claims process. They will be responsible for documenting and entering required information in our systems. The team member is also responsible for ensuring the collection of outstanding accounts from insurance carriers, monitoring claims submission, writing letters of appeal, reviewing, and obtaining necessary documentation to submit claims. He/she will notify the Team Leader and Revenue Cycle Manger of any claim submission errors or specific payer issues to ensure the department.

ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES

• Maintains login credentials and access to all assigned payer portals.
• Maintains productivity metrics by monitoring and working assigned tasks in PM system.
• Responds to all correspondence to clients and RCM team timely.
• Prevents all possible “timely follow-up” denials on claims or appeals.
• Analyzes insurance claims to prevent fraud.
• Documents all medical claims actions and resolutions as specified in SOP.

POSITION REQUIREMENTS

• Claims experience in a hospital or inpatient setting.
• High school diploma or equivalent (GED).
• Medical office experience/medical terminology preferred.
• Accurately maintains and adheres to all safety rules and regulations.
• Detail oriented and has problem solving abilities.
• Proficient in Microsoft Office.
• Working knowledge/experience in electronic medical records and/or other medical software if applicable.
• Able to work with patients and family members in a confident, respectful, and socially professional manner.
• Excellent communication and organizational skills with the ability to work in a fast paced environment; prioritize tasks and workloads.

WORK LOCATION

This is a hybrid/remote position with the expectation of travel to meet the needs of the position. Candidate must reside within 30-miles from the office located in South Bend, IN. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. Must be able to operate standard office equipment and keyboards.

WHY WORK AT AC3?

• Ongoing training, support, and a work culture like no other.
• Medical, dental, and vision health and wellness benefits.
• Employer paid life insurance, long and short-term disability policies.
• Above average paid time out plan and comprehensive wellness program.
• Employee Assistance Services and the opportunity to enroll in a company-matched, 401k plan.