Claims Processing Specialist
1 week ago
At Hanger Clinic, we are dedicated to Empowering Human Potential. As the leading provider of orthotic and prosthetic (O&P) services and products, we deliver advanced O&P solutions, unique clinical programs, and exceptional customer service. Our Patient Care segment operates the largest network of O&P clinics across the nation, while our Products & Services segment distributes both branded and private label O&P devices and components, as well as offering rehabilitative solutions to a wider market. With a legacy of 160 years in clinical excellence and innovation, our vision is to set the standard in the orthotic and prosthetic industry by providing outstanding patient care, superior outcomes, and exceptional value. Every day, our team members positively impact countless lives, helping individuals achieve greater mobility and independence.
Is This Role Right for You?In this position, you will be responsible for the efficient review and submission of medical claims to various insurance providers. You will need to be well-versed in all facets of the financial process, including scheduling, billing, and collections.
Your Contributions:- Conduct thorough reviews of patient invoices for accuracy and completeness.
- Proactively seek out missing information to ensure timely and accurate claim submissions.
- Possess a solid understanding of insurance regulations, including Medicare and Medicaid.
- Follow established billing guidelines, policies, and procedures diligently.
- Identify the correct billing party, whether it be an insurance company or the patient.
- Complete all necessary billing checklists prior to submission.
- Engage in follow-up activities to ensure timely collection of required documentation.
- Communicate effectively with clinic staff and insurance representatives.
- Ensure all necessary documentation is included or coordinate with the appropriate clinic to update records.
- High school diploma or equivalent.
- Demonstrated suitability for the role as assessed by the Talent Bullseye evaluation.
Preferred Qualifications:
- Experience in a healthcare setting.
- Familiarity with electronic medical record (EMR) systems, such as NextGen or OnBase.
- Proficiency in Spanish.
- Knowledge of Durable Medical Equipment (DME) and orthotics.
- Excellent customer service and communication abilities.
- Strong interpersonal skills, both written and verbal, with the capacity to follow instructions accurately.
- A resourceful and adaptable team player who excels in building trust.
- Understanding of HIPAA and medical insurance regulations, including coding and reimbursement protocols.
- Familiarity with ICD-9, ICD-10, HCPC/CPT coding.
- Proficient in computer applications, including Microsoft Office and automated billing systems.
- Ability to operate standard office equipment.
- Knowledge of applicable state and federal collection and reimbursement laws.
- Strong organizational skills with the ability to manage multiple priorities.
- Attention to detail in a fast-paced environment.
- Exhibit enthusiasm and a positive attitude.
- Ability to work independently and demonstrate creativity.
- Familiarity with medical terminology.
- Basic math and accounting skills.
- Commitment to integrity, transparency, and respect in all professional interactions.
- Focus on patient-centered care and building lasting trust.
- Encourage open collaboration and constructive dialogue.
- Drive innovation and adaptability in response to change.
- Strive for superior outcomes and refine processes for exceptional results.
Hanger Clinic is committed to fostering an inclusive workplace, providing equal employment opportunities in all aspects of the employer-employee relationship without discrimination or harassment. We adhere to all applicable employment laws that protect against discrimination based on various characteristics.
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