Claims Representative

1 month ago


Chesterfield, United States Nimble Solutions Full time
Why you'll want to work at nimble

This is a great opportunity to join a well-established and market-leading brand serving a high growth end market while gaining valuable experience and visibility to Executive leadership. As an organization, we are in considerable growth mode through acquisition and with a laser focus on positive culture building.

What you'll do as a Claims Representative...
  • Work with EDI vendors to enroll, map and test all new facilities
  • Submit claims via EDI or paper to insurance carrier within 24 hours of receipt of audited charge sheet
  • Analyze and resolve all PMS scrubbing edits, clearinghouse scrubbing edits and rejections from payers
  • Work and track acceptance and rejection reports
  • Research notices of claims not on file, correcting failures and resubmitting when appropriate
  • Partner with A/R department regarding the resubmission of corrected claims
  • Identify and solution any systems issues that may be causing delays in claims submission
Requirements

Who you are...
  • Minimum of 1 year of RCM experience, claims experience preferred
  • High school diploma
  • Detail oriented
  • Organizational skills
  • Computer knowledge
  • Good written and oral communication skills
  • Knowledge of commonly used insurance billing concepts
  • Experience using Epic
Logistics/Work Environment:
  • Ability to be in office or remote
  • Maintain strict patient confidentiality policies (both medical and financial)
  • Participates in departmental, training and staff meetings
  • Adhere to all compliance policies and procedures
  • All other job duties upon request
  • Reliable transportation (onsite only)

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