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Claims Processing Specialist at Air-Evac Lifeteam in West Plains, Missouri

Posted in Other 30+ days ago.

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Type: Full Time





Job Description:

OVERVIEW

This position is responsible to research, analyze and document non-government insurance Explanation of Benefits (EOBs), Remittance Advices (RAs), and existing contracts in order to gain a thorough understanding of payment methodologies. Must be able to communicate and quantify findings to leadership in a precise, timely and accurate manner.

RESPONSIBILITIES

* Research communicate and educate others on changes that impact reimbursement

* Identify areas of opportunity that occur as a result of a coding or billing error

* Review insurance contracts to gain thorough understanding of payment methodologies

* Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation

* Contact insurance companies to obtain missing information, explain and resolve underpayments and arrange for payment or adjusting processing

* Cultivate patient participation in resolving payment discrepancies with insurance carriers

* Engage employer group Benefits Administrator(s) to review policy terms and provisions

* Initiates and fosters a spirit of cooperation within and between departments.

* Contributes, supports, and develops behaviors that support our cultural I-CARE pillars.

QUALIFICATIONS

Education

* Required high school diploma or equivalent

* Preferred 5+ years in medical billing experience

Skills

* Problem resolution

* Critical thinking

* Auditing

* Required experience working with Explanation of Benefits (EOB)

* Strong working knowledge of a variety of payor performance

* Strong working knowledge of Sweet/Respond billing system

Personal Characteristics

* Organized

* Responsible

* Adaptable

* Self-motivated

* Problem Solving

* Financial Skills

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS

* Work is normally performed in a typical interior/office work environment

* Limited exposure to physical risk

* May be required to sit for long periods of time

* Limited physical effort required

An Equal Opportunity Employer: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

TIME TYPE (PORTAL SEARCHING)

Regular Full-Time