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Title

Insurance A/R Specialist 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
 
Location MedExpress - Southpointe Regional Office  
Full-Time/Part-Time Full-Time  
Category Finance - Billing  
Description

PURPOSE: Responsible for managing the insurance accounts receivables post claims processing to include edits, rejections, and denials.  Accurate claims submission with payee guidelines, timely account follow up and assistance with denial management to ensure the financial viability of the urgent care clinic sites.

WORKING RELATIONSHIPS:  Reports to Teams Lead, Supervisor and Manager of Billing.

RESPONSIBILITIES include but are not limited to the following:

  • Work with insurance carriers to obtain payment on delinquent charges by maintaining a timely follow up process.
  • Preparation and submission of all necessary documentation in order to obtain payment.
  • Responsible for any corrections of edits prior to transmission of electronic claims.
  • Responsible for reconciliation of billing account transactions to ensure accurate information according to established guidelines/procedures.
  • Maintain reasonable aging of outstanding accounts receivable guidelines within CBO-Central Billing Office.
  • Keep current by attending seminars/conferences as approved by Manager.
  • Responsible for monitoring clearing house to ensure timely submission of electronic claims.
  • Responsible for communicating issues and inefficiencies encountered in daily processes.
  • Responsible for maintaining and keeping all edits, denials, and rejections at a current status within the established time frame.
  • Participates in a team effort to fulfill area goals and work requirements. Deals positively with co-workers, supervisors and supports management decisions.
  • Share knowledge and assists others when appropriate.  Utilizes appropriate channels of communication while maintaining complete confidentiality at all times.
  • Maintain current knowledge of major payor payment provisions and regulations; as well as ICD-9 and CPT coding requirements by attending seminars/conferences as approved by CBO Manager.
  • Inform leadership of any problems related to job duties.
  • Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
  • Special projects as assigned by management.

WORK ENVIRONMENT:

  • Works in a clean, well-lighted and ventilated office, and may be required to travel by automobile to various meetings or functions. 
 
Position Requirements

TRAINING AND EXPERIENCE:

  • One (1) to three (3) years previous healthcare billing experience with medical software.
  • Experience when dealing with medical terminology, CPT-4 and ICD-9 required.
  • Organizational skills and ability to multi task in a fast paced environment.
  • High school graduate or GED required.

KNOWLEDGE OF:

  • IDX-GPMS Software desirable, as well as basic knowledge of communications hardware and software. Medical practice operations and centralized patient accounting, Medicare and Medicaid regulations.
  • CPT-4 and ICD-9 codes required.
  • Accounts receivable process and medical terminology.
  • HIPAA as it applies to sensitive information encountered when performing daily processes.

ABILITY TO:

  • Must be able to work independently.
  • Accurately utilize applicable computer software and equipment for claims processing.
  • Demonstrate flexibility to meet the needs of the office in regard to changes in work volume, planned change, scheduling changes, etc.
  • Understand and apply knowledge of established insurance contracts.
  • Good communication and organizational skills with the ability to demonstrate the use of tact and diplomacy in dealing with others.

PHYSICAL REQUIREMENTS: 

  • Requires normal range of eye-sight in order to read, prepare and communicate appropriate information.
  • Must be able to write legibly.
  • Requires eye-hand coordination sufficient to operate computer keyboard, telephone, photocopier, calculator and other office equipment.
  • Requires clear speech and auditory acuity.
  • Moderate physical demands due to prolonged sitting, bending stooping, occasional lifting, stretching and ability to travel in an automobile to perform the tasks associated with managing billing services from various clinics.
  • Ability to sit for extended periods of time.
 
About the Organization MedExpress's vision summarizes the business model and offers insight into the important culture that drives the company's ability to provide a customer experience that is unsurpassed in existing, and other, markets.

Highly-trained professionals are a hallmark at MedExpress. The MedExpress model attracts the best in the business. We carry high expectations for our team:

A 110% commitment to customer service.
Teamwork and patient care require professionalism at all times.
Attention to detail isn't just a statement...we demand it.

Live the vision - Great Care. Fast.®

We offer a competitive salary commensurate with experience and a comprehensive benefits program.  
Exempt/Non-Exempt Non-Exempt  

This position is currently not accepting applications.

To search for an open position, please go to http://MedExpress.appone.com




 


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