Claims Specialist I

2 months ago


Battle Creek, United States Grace Health Full time

We are expanding Grace Health is currently looking for an individual with knowledge of charge entries, billing, and medical coding. We offer competitive wages based on experience and up to 3 weeks of PTO in the first year Other perks include no nights or weekend work and paid holidays. This is an onsite position.Benefits

  • Medical, vision, dental, life, and disability insurance
  • 401K match
  • 8 paid holidays
  • Employee wellness program focusing on physical, mental, and financial wellness
BASIC JOB PURPOSE: Reviews procedure and diagnosis codes submitted by provider, enters charges into Practice Management System, handles correspondence related to patient accounts, answers patient questions about billing procedures

EXAMPLES OF DUTIES: (This list may not be all inclusive.)

  1. Enters charges into Practice Management system submitted from Dental provider (EDR pending charges, or encounter form & off-site charge forms).
  2. Acquires patient billing information from patients and source documents.
  3. Produce claims on regular schedule to Medicare, Medicaid, insurance carriers, and other third-party payers to ensure prompt payment.
  4. Keeps abreast of the various insurance regulations.
  5. Makes recommendations concerning accounts to be written off or turned over for collection.
  6. Enters all actions related to patient's account into Practice Management System as permanent record.
  7. Assists patients with application process for schedule of discounts program.
  8. Facilitates prior authorization for dental procedures.
  9. Manages Senior Millage Program, tracking and reporting.
  10. Works dental tasks submitted by third-party billing company (RCM).
  11. Participates in professional development activities.
  12. Although each position has its own unique duties and responsibilities, please refer to the policy on Job Descriptions for details that apply to every position.

REQUIREMENTS
  • High school Diploma or GED
  • Entry level, 0-3 years coding and/or claims processing experience in a health care organization. Dental billing experience preferred.
  • CPC or similar credentials preferred, although not required

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