Medical Claims Specialist

4 weeks ago


Albuquerque, New Mexico, United States TriCore Reference Laboratories Full time

Job Summary

As a Medical Claims Specialist at TriCore Reference Laboratories, you will be responsible for collecting accounts receivables on patient accounts from various payors, including commercial, non-government, and contracted insurances. Your duties will include routine follow-up on accounts, working the Rejection Report, analyzing aged trial balance reports, and utilizing online insurance resources to obtain current information.

Key Responsibilities:

  • Collect outstanding accounts receivables from patients, commercial, non-government, and contracted insurances or government payors.
  • Pursue collection activities on assigned accounts from primary and secondary payors until worked to resolution.
  • Work account receivables reports, focusing attention on accounts over 60 days.
  • Research adjustments and pull necessary backup to support adjustments.
  • Develop and maintain a professional working rapport with internal and external customers.
  • Identify trends in payment or non-payment of claims and communicate findings to leadership and co-workers.

Requirements:

  • High school diploma or equivalent.
  • One of the following: six months as an Apprentice in the Business Office at TriCore, one year of laboratory or medical claims follow-up/collections experience, or three years of medical billing or claims processing experience.
  • Basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows-based applications.

Preferred Qualifications:

  • Basic knowledge of Excel and Word.
  • Knowledge of medical terminology.


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