Medical Claims Specialist - Front End & Rejections Expert

Maintenance of filing electronic & paper claims as well as managing rejections. Report rejection trends to team leads/managers. Responsibilities: • Claims Processing as per client requirements • Work Rejected & Queued Rejections • Provide feedback to team lead regarding any positive & negative occurrences on accounts • Maintain strict confidentiality within medical practice and HIPAA compliance. • Maintain productivity standards and goals set by the department and/or manager. • Maintain standard quality measures and goals. • Attend Meetings as required and/or participate in various committees as required • Other duties as assigned by, Team Lead, Manager, Director, VP RCM. Required Skills: • High school diploma/GED • Preferably two years’ prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication, including but not limited to: - Explanation of Benefit forms (EOB) - Credit balances (discounts and refunds) - Insurance carrier billing requirements - Collections - Familiarity of payer provider enrollment - CPT & ICD10 Coding Core Competencies: Accountability and Self-Management • Must be detail-oriented and organized • A self – starter capable of tracking to deadlines and meeting goals with little supervision required • A high level of analytical and problem solving skills is expected Team Player • Ability to work autonomously and as a team player Communication • Excellent communication, customer service, and organizational skills • Strong verbal and written communications Innovation and Problem Solving • Attention to detail and moderate analytical and problem solving skills is expected Computer Skills • Must possess general office skills and computer knowledge • Strong working knowledge of the Aprima PM practice management system and/or GE Centricity Business system and coordinating modules, is preferred • MS Excel Spreadsheet software, MS Word Processing software Physical Demands: • May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies. • Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary. • Employee must participate to help maintain the desirable work environment created by the management and company officials. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr