1 Claims Resolution Specialist Job in Bethany, OK
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THE CHILDRENS CENTER INC is Hiring a Claims Resolution Specialist Near Bethany, OK
Job Details
Job Description
Job Purpose
| The claims resolution specialist resolves all unpaid insurance claims by researching all incoming denials. The specialist will monitor the clearinghouse and worklist within the EMR to proactively find and resolve unpaid claims. They will manage all incoming mail/email correspondence from Insurance companies and respond to the requests in a timely manner. The specialist will create a monthly patient statement. They will monitor A/R and work A/R balance due by patient and insurance. The Specialist ensures that billing operations are accurate and efficient and that they conform to the generally accepted principles in the field. They should have excellent communication skills to gather information for other departments within the facility. |
Essential Duties & Responsibilities
| Duty | Percent of Time |
| Follows-up on commercial insurance denials, non-payments, incorrect payments, and patient private balances for Inpatient and Outpatient Claims | 30% |
| Follows-up on Oklahoma Medicaid denials, non-payments, incorrect payments for Inpatient and Outpatient claims. | 30% |
| Updates Inpatient and Outpatient Demographic, Insurance, Authorization, Guarantors, and any other information required for a correct and complete claim. | 15% |
| Evaluates A/R reports to prevent timely filing and loss of revenue from denial or missed opportunities. | 15% |
| Communicate with Referral, Authorization and Registration Department to Get information needed for claim payments. | 5% |
| Other duties as assigned. | 5% |
Qualifications
| Education: | High School Diploma or equivalent |
| Experience: | 1 years of experience in outpatient and Inpatient Commercial Insurance and Medicaid claim denial management. 1 years of experience in a healthcare environment preferred. ICD-10 and CPT-4 coding experience preferred. 1 years of Meditech experience preferred. Proficient at MS Excel and MS Word Preferred. |
| License/Certification/Credential: | N/A |
About Us
Our work begins where we are all equal - at the heart.
Bethany Children’s Health Center is an innovative leader in the field of pediatric rehabilitation and 24-hour complex care. The hospital offers inpatient and outpatient services for children (ages 0-21) and is the only inpatient pediatric rehabilitation facility in Oklahoma. Our CARF accredited multidisciplinary team works with patients and their families to maximize the patient’s physical and cognitive potential, and ensure the family has the training and resources needed for a smooth transition from hospital to home. In 2021, the hospital received accreditation from The Healthcare Facilities Accreditation Program (HFAP), the nation’s original independent accreditation program recognized by the Centers for Medicare and Medicaid Services (CMS). This distinction confirms that Bethany Children’s Health Center is providing high quality patient care as determined by an external process of evaluation.
In order to maximize the potential of every child, we must maximize the potential of every employee. We are committed to providing staff with the physical, emotional, spiritual, financial and mental resources necessary to achieve their potential and meet our standards of excellence. BCHC offers competitive compensation, benefits, state-of-the-art equipment and wellness programs. Opportunities for professional growth include in-service training, leadership development, tuition reimbursement and scholarships.
**Due to the nature of our pediatric services, this organization’s positions are classified as safety-sensitive roles. Bethany Children’s Health Center may refuse to hire an applicant or discharge an employee in a safety-sensitive position, who tests positive for marijuana even if the applicant or employee holds a valid Oklahoma medical marijuana license.
Job Summary
Other
Preschool & Daycare
$66k-80k (estimate)
03/05/2024
05/03/2024
childrenscenterva.com
SUFFOLK, VA
200 - 500
1983
LATOSHA RUSSELL
$10M - $50M
Preschool & Daycare
Related Companies
About THE CHILDRENS CENTER INC
The Childrens Center is a nonprofit organization management company based out of United States.
The job skills required for Claims Resolution Specialist include Communication Skills, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Resolution Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Resolution Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Claims Resolution Specialist positions, which can be used as a reference in future career path planning. As a Claims Resolution Specialist, it can be promoted into senior positions as a Claims Adjuster III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Resolution Specialist. You can explore the career advancement for a Claims Resolution Specialist below and select your interested title to get hiring information.
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