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Healthcare Claims Processing Specialist

2 months ago

Rochester, Michigan, United States TEKsystems Full time
Job Overview

Position: Healthcare Claims Processing Specialist

Working Hours:

Full-time position, requiring flexibility for Monday through Friday, from 8:00 AM to 5:30 PM.

Location: This is an onsite position; candidates must be local or willing to commute.

Key Responsibilities:

  • Manage daily assignments from the billing software system efficiently.
  • Input and process data pertinent to patient services and reimbursement.
  • Verify that all patient documentation is complete and accurately filed.
  • Engage with insurance providers via phone or online platforms regarding outstanding claims and respond to their correspondence.
  • Review and correct minor errors in low-value claims for resubmission to payors.
  • Analyze accounts receivable aging reports for payors.
  • Examine claims forms for primary, secondary, and tertiary insurance payors as necessary.
  • Act promptly on accounts to ensure proper claims processing.
  • Deliver outstanding customer service to both internal and external stakeholders.
  • Assess HCPC, modifiers, and ICD-10 codes for precision while adhering to compliance and coverage guidelines.
  • Meet performance standards by adhering to productivity, quality, and customer service benchmarks set by the organization.
  • Ensure compliance with Corporate Compliance and HIPAA regulations.
  • Undertake additional tasks and special projects as required.

Required Skills and Qualifications:

  • A minimum of one year of experience in a fast-paced office environment focusing on medical claims.
  • Familiarity with Medicaid and Medicare processes is advantageous.
  • Demonstrated proficiency with technology, particularly Microsoft Office applications.

About TEKsystems:

At TEKsystems, we are dedicated to driving transformation. We empower clients to realize their ideas and solutions, seizing opportunities in a rapidly evolving landscape. Our team comprises 80,000 professionals collaborating with over 6,000 clients, including a significant portion of the Fortune 500, across North America, Europe, and Asia. As a leader in Full-Stack Technology Services and Talent Services, we partner with innovative leaders to facilitate change. This is the essence of true collaboration. TEKsystems is part of the Allegis Group.

We are an equal opportunity employer and welcome applications from all individuals, regardless of race, gender, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.