Large Medical Billing and Management company is seeking an experienced Billing Claims Specialist in our Hamilton New Jersey office. This position is located in Hamilton Township, Mercer County on Quakerbridge Road. Convenient to the Trenton Area.
- Monitor and analyze insurance claims and denials by running reports and contacting insurance companies for claim resolution
- Identify problem accounts and trends in claim issues escalating them as appropriate
- Update patient account records detailing action taken on the account as well as claim status
- Compose letters to explain reasons for appeals
- Research and identify coding or clinical documentation issues and correct errors in a timely manner for maximum reimbursement
- Perform all types of complex adjustments to patient accounts and resolves any issues
Responsible for all aspects of follow up and collections, including making telephone calls, accessing payer websites. Identify issues or trending and provide suggestions for resolution. Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues.
- Must be able to read and understand an EOB;
- Conduct all job tasks, calls, duties, and interactions with professionalism, respect, a positive attitude, and in accordance with company compliance policies and applicable government regulations;
- Consistently support and demonstrate the company mission and values;
- Maintain or exceed specified performance standards for each client;
- Ability to organize, prioritize and multi-task;
- Ability to learn, understand, and work within specific compliance, client, and payer requirements;
- Approach all tasks, duties, and interactions with an attitude of continuous improvement;
- Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods;
- Willing and able to adapt to changes in work environment, procedures, priorities, and job duties;
- Ability to function well within a cross-functional team setting and independently;
- Must possess critical thinking/analytical skills;
- Proficient in Microsoft Office programs especially Excel and Outlook.
- High school diploma or equivalent.
We offer an excellent benefits package that includes Medical, Dental and Vision insurance as well as 401K, Life Insurance, STD and LTD. Paid holidays, vacation time, sick days and personal time. Business casual work environment.