Accounts Receivable Claims Specialist (Chesapeake Specialty Care)

The Accounts Receivable Claims Specialist is responsible for working with payors to resolve payment denials, both partial and full.

ESSENTIAL FUNCTIONS

• Stay current on payer policies and coverage guidelines.
• Identify payment denials through the work queue and take appropriate action to resolve.
• Communicate professionally with providers when necessary to resolve denied claims.
• Resubmit Corrected Claims based on payor policies or Provider directions.
• Appeal claims denials with required information to have claims adjudicated properly.
• Stay current on correct appeal processes for Payors assigned.

EDUCATION and/or EXPERIENCE

• High school diploma or equivalent
• Minimum 2-3 years of experience in medical billing
• Experience with practice management systems and EHR platform

KNOWLEDGE AND SKILLS

· Familiarity with medical terminology and CPT/ICD-10 codes

· Strong knowledge of medical insurance plans (commercial, Medicare, Medicaid, Tricare)

· Knowledge of basic medical coding and third-party operation procedures and practices.

· Familiarity with Microsoft applications, including, but not limited to Word and Excel.

· Excellent communication and customer service skills

· Strong written and verbal communication skills including the ability to confidently speak to patients

· Excellent organizational skills to manage multiple tasks throughout the day.

ABILITIES

· Ability to operate a multi-line telephone system and answer a telephone in a pleasant and helpful manner.

· Demonstrate the ability to work as a team player in a very cohesive medical practice.

· Ability to communicate and work well with co-workers. Open and honest communication.

· Ability to effectively communicate orally and in writing with internal and external business professionals.

· Must be responsible, reliable, and able to carry out job functions

Total Rewards

The referenced base salary range represents the low and high end of Specialty Care Networks’ salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate’s geographical location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/ training and other qualifications. Specialty Care Network offers a total rewards package that supports our employee’s life, career and retirement.