Claim Specialist

4 weeks ago

Greensboro, United States Eagle Physicians Full time
Location: Eagle Business Services

Eagle Physicians & Associates - Business Services is seeking an experienced and detail oriented Claims Specialist to join our team. Qualified applicants will have a minimum of 1 year prior experience in medical billing for primary care physicians. Eagle offers competitive pay and a generous benefits package.

Our employees love working at Eagle For 3 consecutive years, staff consistently rank Eagle highly on their annual Employee Engagement Surveys. 92.80% of Eagle employees cite that they see themselves at Eagle a year from now and recommend Eagle as a great place to work

Come join our team and be part of an enriched and satisfied workforce.

** Eagle Physicians may pay all support staff employees hired as a .50 FTE or higher on-or-after April 1, 2024, structured bonuses over their first two years of employment with Eagle as outlined provided. Bonus Amounts are $750.00 at 6 months, $750.00 at 12 months, $1,000.00 at 18 months and $1,000.00 at 24 months.

Paid Maternity/Paternity leave- Eagle provides up to 2 weeks of paid maternity/paternity leave after 1 year employed and 1,250 hours worked for the birth or adoption of a child. Time is pro-rated based on FTE status.

Influenza vaccine required as a condition of employment, please direct questions to Eagle HR. Eagle is an Equal Opportunity Employer.

Schedule: Generally, Monday - Friday 8 AM-5 PM. Schedule subject to change as indicated by manager. Position may offer a hybrid work schedule with some remote work in the future.

Key Responsibilities:
• Work all assigned claims within specified time period.
• Review all assigned claims for correct assignment of ICD-10, CPT, HCPCS codes and modifiers.
• Follow protocol when billing selected services and performing specific claim functions.
• Maintain knowledge of insurance carrier specific billing requirements and apply to claims as needed.
• Maintain knowledge of Correct Coding Initiative (CCI) and familiarity with all major coding resources
• Correct all identified errors on claims prior to submitting.
• Correct all returned claim denials assigned to you in a timely manner.
• Assist EDI, Insurance, and Customer Service Representatives in resolving claims issues.
• Communicate with site administration or providers as needed.
• Writes legibly and with correct grammar and sentence structure.
• Participates in professional development activities and maintains professional affiliations.
• Shows respect, courtesy and advocacy in all dealings with all people, including, but not limited to patients, coworkers, and visitors.
• Displays a positive attitude, and team-oriented spirit, indicated by a willingness to assist where and whenever needed.
• Attends meetings as required.
• Follows HIPAA guidelines for patient confidentiality and maintains security of Protected Health Information (PHI) and business information.
• Does not exhibit, divulge, copy or remove the contents of any record or report except to fulfill work assignments.
• Participates in professional organizations as indicated.
• Upholds and exemplifies through daily actions, activities and behaviors Eagle's Diversity, Equity, and Inclusion values.
• Upholds and exemplifies through daily actions, activities and behaviors Eagle's Vision, Mission and Values:
o Vision: Eagle Physicians will be seen as the healthcare organization of choice by patients, staff and the community.
o Mission: Eagle Physicians will provide patient-centered healthcare for our community with a team committed to high-quality, supportive and compassionate care.
o Values: Integrity, Compassion, Trust, Professionalism and Respect.
• Performs additional duties as required.

PERFORMANCE REQUIREMENTS:

Knowledge, Skills & Abilities

Must have strong attention to details. Must be able to prioritize, be organized and be able to multi-task. Must have strong computer skills. Must have understanding of insurances and healthcare billing. Have knowledge of anatomy, physiology, and medical terminology necessary to correctly review claims for accuracy. Ability to examine documents for accuracy and completeness. Ability to work effectively with sites and co-workers. Ability to read and understand oral and written instructions. Ability to follow written protocols. Ability to work independently. Ability to communicate clearly. Must have a pleasant nature and professional personal and telephone skills.

Education: High School diploma or GED

Experience: Minimum 1-year medical billing and claims processing experience. Good understanding of medical diagnosis and procedural coding requirements. Good knowledge of medical insurance billing requirements and above average computer skills. Knowledge of eClinical Works preferred.

Certificate/License: None

ALTERNATIVE TO MINIMUM QUALIFICATIONS: None

Other details
  • Pay Type Hourly


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