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Medical Claims Specialist

1 month ago

Chesapeake, Virginia, United States Bayview Physicians Group Full time
Job Description

Bayview Physicians Group is a rapidly growing outpatient multi-specialty medical group that prioritizes the doctor-patient relationship as the cornerstone of quality healthcare. We have over 600 positions in the Hampton Roads area, and we're looking for individuals with excellent customer service skills, strong collegial relationships, and a desire to promote a positive work environment. Our competitive benefits package is available to full-time employees, and we're always accepting applications from qualified candidates.

Duties & Responsibilities:

  • Track claims with insurance companies and follow up on outstanding unpaid claims.
  • Work on unpaid claims and credit reports, researching and processing rejected or suspended claims.
  • File appeals and documentation to insurance companies for payment reconsideration.
  • Audit patient accounts to determine when refunds are due and request refunds.
  • Assist patients with insurance billing and account balance issues/questions.
  • Identify delinquent accounts and route them to the collections department staff.
  • Maintain changes and updates in insurance policies/procedures to staff.
  • Participate in specialized seminars as required and training as needed.
  • Identify, research, and communicate insurance changes, provider participating status, and other new information to appropriate staff.
  • Assist other account representatives as needed to maintain workload.
  • Work on Practice Management claims, edits, validations, and clearinghouse carrier edits.
  • Maintain confidentiality regarding patient account status and the financial affairs of the clinic/corporation.
  • Maintain annual compliance education.
  • Regular and reliable attendance and present to work on time as scheduled.
  • Perform other duties as assigned by supervisor.

Qualifications:

  • General knowledge of medical practices, including exceptional interpersonal skills.
  • Ability to organize and effectively work on multiple projects at one time.
  • Ability to communicate effectively orally and in writing.
  • Excellent telephone skills.
  • Must demonstrate the ability to work as a team member.
  • Must demonstrate a positive attitude and helpful demeanor.
  • General knowledge of standard office equipment such as computers, fax machines, photo copiers, etc.

Education and/or Experience:

  • Minimum of 1 year previous medical experience required.

Supervisory Responsibilities:

None