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MedPro Claims Research Specialist lll

3 months ago

Pensacola, United States West Florida Medical Center Clinic PA Full time
Job Type

Full-time

Description

JOB SUMMARY

Under the direction of the MedPro Claims Research Supervisor, the Claims Research Specialist III is responsible for performing the duties related to insurance follow up/collection and maintaining of accounts receivables.

ESSENTIAL DUTIES AND RESPONSIBILITIES
  • Ability to work all carriers accurately and efficiently including "Special Accounts" (i.e. WC, MVA, etc.)
  • Work weekly worklist:
  1. Carrier specific worklist daily
  2. No activity
  3. Manager Respond (Goal: 48 hours)
  • Ability to effectively and efficiently work client specific claims as outlined in MedPro/client contracts.
  • Work insurance requests.
  • Work correspondence.
  • Work rebilled HCFA claim forms.
  • Respond to questions from MedPro customers and billing staff related to insurance or account A/R activity in a courteous and professional manner.
  • Communicate with Claims Research Supervisor on carrier trends
  • Perform error corrections.
  • Ability to effectively communicate via claim notes per MedPro policy and procedure.
  • Update patient accounts with the correct insurance information.
  • Refile coding denials with appropriate material received from the Consultant Practice Manager (CPM).
  • Complete assigned projects within deadline, as directed by the Claims Research Supervisor.
  • Perform daily functions with minimum guidance from Claims Research Supervisor.
  • Accurately follows written and verbal instructions.
  • Other duties as assigned by management are accepted willingly and completed in a timely manner.

CORPORATE CULTURE RESPONSIBILITIES
  • Follow established corporate and department-specific policies and procedures.
  • Attend all corporate and department-specific required training.
  • Uphold MCC's Purpose, Values, and Vision.
  • Abide by MCC's Corporate Culture Responsibilities.
  • Perform other duties as may be assigned cheerfully and willingly.

Requirements

EDUCATION/EXPERIENCE REQUIREMENTS
  • Minimum education requirement is high school diploma, or equivalent.
  • Minimum 1-year insurance billing experience or equivalent.
  • Minimum 1-year medical billing software or equivalent.

KNOWLEDGE, SKILLS AND ABILITIES
  • Ability to prioritize and manage multiple tasks.
  • Displays customer services skills, strong interpersonal skills, close attention to detail, excellent verbal and written communication skills, and basic math skills.
  • Be a person of integrity and character, willing to embrace change and make a positive impact in the lives of patients and co-workers.
  • Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
  • Displays computer proficiency (i.e. PC Windows, MS Office) and ability to quickly learn new applications.
  • Acceptable typing speed and accuracy with ten-key by touch skills.
  • Proficient in use of English language both in written and verbal communication.
  • Must be able to communicate with individuals of varying socio-economic backgrounds.
  • Must be committed to the protection of confidential information, records and/or reports.
  • Possess strong critical thinking and analytical skills.

PHYSICAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS
  • Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
  • Standing/Walking: Occasionally; activity exists up to 1/3 of the time
  • Keyboarding/Dexterity: Frequently; activity exists from &fac34; of the time
  • Ability to look at a computer screen for extended periods.
  • Ability to perform constant repetitive hands and finger motions.
  • Ability to maintain focus while working in close proximity to others.
  • Talking (Must be able to effectively communicate verbally): Yes
  • Seeing: Yes
  • Hearing: Yes

EMOTIONAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS
  • Must exhibit stable work behaviors daily.
  • Must possess adequate individual coping skills.
  • Ability to remain calm and professional regardless of workload or time constraints.
  • Must be able to work under stress and remain calm and professional.

WORK ENVIRONMENT
  • Office environment
  • Exposed to frequent and constant interruptions in daily functions/schedule.
  • May be required to work extended hours to meet department needs.