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MedPro Claims Research Specialist lll
3 months ago
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:
- Carrier specific worklist daily
- No activity
- 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.