Claims Representative
1 month ago
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
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
- 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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