Position Summary:
Please submit your resume to hr @ riverkidstexas.com. Only applicants who submit an email will be considered for the position. Be sure to include the title of the position in the subject bar.
Position Summary:
- The Medical Claims Specialist is accountable for the following: Perform accounts receivable follow-up/collection procedures to obtain timely reimbursement from commercial, Medicaid and third-party carriers. Maintain contacts with insurance companies and communicate billing/reimbursement changes to management in timely manner. Assist in evaluation of A/R and participate in development of collection strategies to decrease outstanding A/R.
Essential Responsibilities:
- Extract, review and interpret insurance EOB’s, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers while resolving account balances.
- Proactively identify opportunities to improve business results and/or to alert business units of trends, anomalies or health plan rules and decisions that need attention.
- Escalate unresolved issues appropriately and recommend solutions to minimize future problems.
- Post payments from EOB’s and be familiar with deductible, co-pays and co-insurance
- Process online secondary claims with commercial and Medicaid carriers
Qualifications: Required
- High School Diploma/GED
- Minimum two (2) years collection or billing practices
- Minimum 1 year working remotely
- Experience and proficiency using an automated billing system.
- Skill in defining problems, collecting data and interpreting billing information.
- Ability to examine documents for accuracy and completeness to prepare records in accordance with detailed instructions.
- Proficiency in use of computer
- Knowledge of ICD9, ICD10, and CPT4 coding as it relates to third-party carrier reimbursement.
- Knowledge of third-party carrier operating procedures and practices, particularly as they relate to levels and methods of reimbursement
Job Type: Full-time
Pay: From $16.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Schedule:
Work setting:
Location:
Work Location: Remote