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Clinical Claims Specialist

1 week ago

New Lenox, Illinois, United States Silver Cross Hospital Full time

Silver Cross Hospital is a leading healthcare provider known for its commitment to excellence and patient-centered care. As a Clinical Claims Specialist, you will play a critical role in ensuring the accuracy and efficiency of our claims processing.

Key Responsibilities:

  • Process electronic and paper claims for Medicare and Medicare Advantage billing according to CMS and Payer guidelines.
  • Analyze and correct rejections received from Payers or hospital system reports.
  • Follow-up on related correspondence and interact effectively with co-workers.
  • Handle incoming departmental calls and perform general office duties as assigned.

Essential Skills and Qualifications:

  • Ability to understand CMS rules and ensure hospital compliance with billing.
  • Understanding of additional billing requirements enforced by Medicare Advantage Payers.
  • Knowledge of LMRP and CCI edits and ability to identify and process them.
  • Familiarity with Experian billing software and CMS DDE system.
  • Excellent customer service skills and ability to maintain confidentiality.

Benefits:

  • A competitive salary range of $17.99 - $22.48 per hour.
  • A comprehensive benefits package including medical, dental, and vision plans, life insurance, flexible spending account, and 401(k) plan with a match.
  • Opportunities for professional growth and development through tuition reimbursement and wellness program.

About Silver Cross Hospital:

We value our employees and strive to provide a supportive work environment that promotes teamwork and excellence. If you are a detail-oriented and organized individual with a passion for delivering exceptional patient care, we encourage you to apply for this exciting opportunity.