Medical Claims Processor

3 days ago


Florence, South Carolina, United States HopeHealth Inc Full time
Job Description

Overview of the Position:

We are seeking a highly skilled Billing Specialist to join our team at HopeHealth Inc. The successful candidate will be responsible for processing healthcare claims to obtain reimbursement from insurance companies and government healthcare programs.

Key Responsibilities:

  • Validate the accuracy of claim information to ensure effective billing and follow-up activities.
  • Apply approved adjustments to accounts according to departmental and company policy.
  • Scrub claims for errors and mark corrections per departmental and payer guidelines.
  • File electronic and hard copy claims daily.
  • Process mail and direct correspondence related to open accounts to secure payment.
  • Provide assistance to other department staff with questions or problems related to patient payments and adjustments.
  • Receive incoming calls from patients and/or insurance companies and provide information in a courteous and cooperative manner.

Requirements:

  • High School Diploma or GED required; Associates degree in a related field preferred.
  • 1-2 years of medical billing and follow-up experience desired.
  • CPC and/or CPB or similar certification highly desired but not required.
  • eClinicalWorks experience preferred.
  • Proficient with Microsoft Office Suite, specifically Excel, Word, and PowerPoint.
  • Advance and current working knowledge of ICD-10, CPT, and HCPCS codes.
  • Current knowledge of insurance payer coding and reimbursement guidelines.

Physical Requirements:

  • Ability to communicate in the dominant language of the geographic region.
  • Ability to lift 30 pounds.
  • Corrected vision and hearing within normal limits.
  • Manual dexterity to key in data and utilize computer.

Working Conditions:

The Billing Specialist will work in a high-pressure environment and must be able to adapt to change. The successful candidate will be able to demonstrate a positive patient/customer service attitude and possess excellent communication skills.


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