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Claims Specialist

3 months ago

Taunton, United States RemX Full time

RemX is seeking a Claims Specialistin the Taunton, MA area

Responsibilities:

  • Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing
  • Research, analyze and appropriately resolve rejected claims
  • Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Contact providers and/or customers as necessary to obtain additional information needed for claims processing
  • Monitor and resolve at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Work as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Timely complete, communicate and submit necessary payer paperwork including but not limited to benefit eligibility assessment, claim to old overrides and manual claim forms
  • Review and work convert billing exception reports to ensure claims are billed to accurate financial plans
  • Complete billing transactions for non-standard order entry situations as required
  • Prepares and maintains reports and records for processing
Qualifications:
  • High School Diploma/GED
  • Associates degree, 4 year college or technical degree, desired
  • Required: 1 year insurance billing experience
  • Third Party Billing or collections/billing experience in the healthcare industry, desired
  • Ability to meet deadlines
  • Proactive, forward thinking and comfortable asking questions
  • Able to work independently without supervision and with others as a team
  • Strong Analytical Skills, Excellent time management and attention to details
  • Working knowledge in MS Office Products (Excel, Word) and basic computer knowledge
  • Comfortable making phone calls and interacting with internal/external entities
  • Excellent interpersonal, written and communication skills
  • Organizational skills, high level of accuracy, attention to detail, time management skills
  • Proficient skills in Microsoft Office
  • Ability to problem solve under pressure with tight deadlines
As a RemX Claims Specialist We Offer You:
  • Competitive pay
  • Paid weekly (Direct Deposit or ATM Debit Card available)
  • Access to health benefits and retirement plan
  • A personal recruiter to help with job searches and assistance when at work
  • FREE ONLINE skills training
  • Contract-to-Hire Opportunity

Find A Job That Works for You

Each day RemX puts over 90,000 people to work, helping more than 15,000 companies find the talent they need to succeed. And, as a part of the 10th largest staffing company in the world, we understand that at the heart of every successful business are people. That's why we work hard to find you the right job at the right company. Explore all the exciting opportunities RemX offers and find the right job for you