Medical Claims Specialist
3 days ago
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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