Medical Claims Examiner/Scheduler

3 weeks ago


The Woodlands, United States The Woodlands Specialty Hospital Full time

The Woodlands Specialty Hospital is seeking a skilled Medical Claims Examiner/Scheduler to join our team.

Job Summary

We are looking for an experienced professional to verify medical insurance benefits, initiate and follow up on pre-certification, and read doctor's orders. The ideal candidate will have knowledge of traditional Medicare Part A & B, Medicare Advantage, and Medicare Replacement plans.

Key Responsibilities
  • Verify medical insurance benefits through payer websites and/or by phone with NPI and TAX ID
  • Initiate and follow up on pre-certification
  • Read doctor's orders
  • Familiarity with procedure and diagnosis codes-CPT codes and ICD10 codes
  • Knowledge of in-network/out-of-network benefits
  • Experienced financial counselor-understands how to calculate benefits and collect from patient financial responsibility
  • Familiarity with radiology (CT, MRI, X-RAYS, NUCLEAR MEDICINE, etc.)
  • Knowledge of outpatient surgery procedures
  • Experience with registration and scheduling in Athena Software
  • Familiarity with medical terminology
Requirements
  • Bachelor's degree or equivalent experience
  • Minimum 2 years of experience in medical claims examination and scheduling
  • Excellent communication and organizational skills
  • Ability to work in a fast-paced environment
  • Proficiency in MS Word, Excel, and Outlook email
Benefits

We offer a competitive salary range of $45,000 - $60,000 per year, depending on experience. Additionally, we provide excellent benefits, including health insurance, retirement plan, and paid time off.



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