Medical Claims Specialist

3 days ago


Manchester, New Hampshire, United States Centerprise Full time
Job Title: Medical Claims Specialist

We are seeking a highly skilled Medical Claims Specialist to join our team at Centerprise Inc.

Job Summary:

The Medical Claims Specialist will be responsible for performing a variety of billing and administrative tasks, including claim submission, claim correction, insurance follow-up, and appeals. They will also assist with all other billing and finance duties as needed.

About the Company:

Centerprise is a professional services organization providing consulting and Revenue Cycle Management services to Federally Qualified Health Centers (FQHCs). We are a dynamic and growing company with a strong focus on employee satisfaction.

Key Responsibilities:

  • Monitor patient account insurance balances to ensure timely payment and resolve any outstanding issues.
  • Communicate with payers regarding payment status and resolve incorrect payment issues.
  • Manage denied claims and work closely with leadership to address and resolve any denied claims promptly.
  • Stay informed about government and non-government contractual billing and follow-up guidelines to ensure compliance with individual payer requirements.
  • Address issues related to lack of payment or improper payment by government, non-government, and self-payers.

Qualifications:

  • High School Diploma or Equivalent (GED), associate degree preferred.
  • Medical billing experience required, with FQHC billing experience a plus.
  • Proficiency with Microsoft Office Suite, including Excel spreadsheets.
  • Knowledge of Medical Terminology, CPT and ICD-10 Coding, Electronic Billing, and HIPAA.
  • EHR experience required, with preferred experience in NextGen or eClinicalWorks.
  • Excellent written and oral communication skills.

Benefits:

  • Competitive benefits package, including options to enroll in health, dental, vision, life, short-term disability, long-term disability, and flex savings accounts.
  • 401(k) Program with a competitive company match.
  • Courtesy Plan, full-time staff and their immediate family members are eligible for courtesy treatment at any HealthSource of Ohio office up to $500.00 per family.
  • PTO and Long-Term Sick Bank, full-time employees earn up to 25 days per year in the first calendar year.
  • Credit Union Privileges, Sharefax Credit Union.
  • Quarterly Bonus Incentive Program.

Schedule:

  • Monday to Friday, with no evenings or weekends.
  • After training, may be eligible to work a hybrid-remote schedule with 2-3 in-office days per week.

Work Location: Loveland, OH 45140. Must be able to commute or plan to relocate before starting work.

Centerprise Inc. is an Equal Opportunity/Affirmative Action Employer: Minority/Female/Disabled/Veteran.



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