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Claims Specialist
2 months ago
About the Role:
Addus HomeCare Corporation is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will play a critical role in ensuring the smooth operation of our revenue cycle process.
Key Responsibilities:
- Insurance Benefit Investigation: Conduct thorough investigations of new referrals to determine insurance coverage and benefits.
- Claim Submissions: Accurately review and submit claims to various payers, ensuring compliance with regulations and guidelines.
- Revenue Cycle Support: Provide support to the revenue cycle team, including data entry, research, and analysis.
- Communication: Effectively communicate with insurance companies, patients, providers, and prescribers to resolve reimbursement issues and ensure access to care.
- Account Management: Review and manage unpaid accounts to determine status and take appropriate action to ensure payment.
- Compliance: Ensure all claims submissions comply with Medicare, Medicaid, and HIPAA regulations.
- Customer Service: Maintain a high level of customer service, responding to inquiries and resolving issues in a timely and professional manner.
Requirements:
- Education: High school diploma or equivalent required; undergraduate degree preferred.
- Experience: Experience in medical billing, accounts receivable, and/or collections within a healthcare or insurance environment preferred.
- Skills: Quick and accurate data entry skills, computer proficiency in MS Office and web-enabled applications, and understanding of Medicaid, Medicare, and insurance billing requirements.
