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Medical Claims Specialist

2 months ago

Conway, Arkansas, United States Reach Therapy Services Llc Full time
About the Role

We are seeking a highly skilled Medical Claims Specialist to join our team at Reach Therapy Services LLC. As a Medical Claims Specialist, you will play a critical role in ensuring the smooth operation of our billing and credentialing processes.

Key Responsibilities
  • Learn and understand various funding options available for families and educate them on the application process.
  • Understand and complete the credentialing process for providers, ensuring timely and accurate submissions.
  • Manage patient account balances, post payments electronically, and monitor EOBs and notices from funding sources.
  • Work with funding sources to resolve payment issues in a timely manner and notify staff of any problems.
  • Stay current on payer updates and recommend software updates to ensure compliance.
  • Follow up on past due claims and research as necessary to ensure timely collection of funds.
  • Assist patients with billing questions and provide estimates.
Requirements
  • Strong skills in time management, organization, and prioritization.
  • Attention to detail and accuracy in processing claims and managing patient accounts.
  • Excellent verbal and written communication skills for effective collaboration with team members and patients.
  • Flexibility to work independently and as part of a team.
  • Results-oriented and self-motivated with a strong work ethic.
  • Working knowledge of third-party payers, ERAs, EOBs, and payer-specific guidelines.
  • Understanding of health plan benefits, eligibility verification, and CMS billing rules.
  • Experience with EMR systems and strong computer skills, including MS Word, Excel, and Outlook.
Education and Experience
  • High School Diploma or equivalent required.
  • EMR/EHR system experience required.
  • Billing knowledge required.