Medical Claims Technician I

Job Description

Job Description

SUMMARY

Researches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Researches denial of claims, evaluates and rebills as necessary in an effort to ensure the maximum accurate payment and reduce the number of A/R days
• Communicates with Business Office or clinical staff regarding coverage and denials, if appropriate
• Sustains aged A/R of less than 120 days
• Maintains a high level of integrity and commitment to accurate claims processing
• Performs other duties as required

QUALIFICATIONS

• One year of experience with insurance billing and claims research preferred
• High school or equivalent with emphasis on business related courses
• Ten key, computer/data entry, spreadsheets, and word processing
• Communication, analytical and problem solving skills
• Ability to multi-task and meet deadlines
• Detail oriented and organizational skills
• Excellent verbal and written communication skills
• Ability to work independently and collaboratively within a team environment
• Commitment to the mission of Red Rock BHS

PHYSICAL REQUIREMENTS

• Must have the ability to stand or sit for long periods of time
• Must have the ability to lift, push, or pull a minimum of 25 pounds
• Ability to travel approximately 10% of the time
• Ability to use telephone, PC, fax machine, copy machine, and printer

HOW WE TAKE CARE OF YOU!

• We pay a generous portion of your Health Insurance
• Low-cost Dental and Vision Insurance
• Retirement Plan with employer contributions equal to 5% of annual salary
• Student Loan Repayment options
• No cost Employee Assistance Plan
• 3 Weeks Paid Time-Off (increases annually between years 2-10)
• 9 Paid Holidays
• 1 Floating Holiday to use at your discretion.
• 4 Rest and Relaxation days
• 3 days of Education Leave
• 4 hours of Volunteer Leave
• Eligible for Pay Increases and Bonuses annually
• Employer Paid Long-Term Disability and Life Insurance

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

Red Rock Behavioral Health Services does not discriminate based on race, color, national origin, religion, gender, gender identity, age, marital/familial status, sexual orientation, or disability.