Medical Claims Specialist
1 month ago
Job Summary
We are seeking a highly skilled Medical Claims Specialist to join our team at TriCore Reference Laboratories. As a Medical Claims Specialist, you will be responsible for collecting accounts receivables on patient accounts, non-government, and contracted insurances government payers and secondary billing.
Key Responsibilities:
- Collect outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration.
- Pursue collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration.
- Work account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days.
- Research adjustments and pull all necessary backup to support adjustments.
- Utilize on-line insurance resources to obtain and maintain current information.
- Develop and maintain a professional working rapport with internal and external customers to include contacts with insurance company representatives.
- Identify trends in payment or non-payment of claims. Communicate findings to leadership and co-workers as appropriate.
- Customize reports in Antrim and or Excel to prioritize accounts for collecting.
Requirements:
- High school diploma or equivalent.
- One of the following:
- Six (6) months as an Apprentice in the Business Office at TriCore.
- Minimum of one (1) year of laboratory or medical claims follow-up/collections experience.
- Minimum of three (3) years of medical billing or claims processing experience.
- Basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications.
- Typing speed of 30 words per minute.
Preferred Qualifications:
- Basic knowledge of Excel and Word.
- Knowledge of medical terminology.
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