JOB DESCRIPTION OVERVIEW :

Position is responsible for reviewing assigned denials to ensure claims are being processed correctly and efficiently.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

Reviews assigned denials to determine appropriate action based on payer requirements.

Assembles and prepares required documentation for appeal in billing system to appeal disputed claims.

Assembles and forwards required documentation for payer guidelines.

Maintains working knowledge of carrier requirements for claim appeals and claim appeal billing systems.

Identifies and report consistent errors that impact claims from being processed correctly.

Performs additional duties and assignments as requested.

QUALIFICATIONS / EXPERIENCE :

High school diploma or equivalent required.

Two-years previous medical billing experience preferred with emphasis on research and claim denials in Accounts Receivable preferred.

Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, appeals process and physician billing preferred.

Proficient in Microsoft Office.

Must possess excellent oral and written communication skills.

Must be well-organized and possess ability to follow-up on claims.

Must be self-motivated.

SUPERVISORY RESPONSIBILITIES :

None

PHYSICAL / ENVIRONMENTAL DEMANDS :

This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer

This position may require manual dexterity and / or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and / or the ability to perform repetitive motions and / or meet production standards to comply with the essential functions.

Also, may require physical and / or mental stamina to work overtime, additional hours beyond a regular schedule and / or more than five days per week.

Pay Details : $ per hour

Search managed by : Joseph Ardaiolo

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan.

Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs.

In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.