Medical Claims Data Entry Specialist (REMOTE)

Job Description

Position Summary: Reporting to the Revenue Cycle Supervisor, the Medical Claims Data Entry Specialist provides end-to-end revenue cycle responsibilities and account management. This individual will work in multiple systems based on the client’s needs. We are looking for an ambitious individual to impact and expand our rapidly growing team. As a Revenue Cycle Specialist, you will play a crucial role in supporting our clients.

Essential Duties and Responsibilities

• Ensures compliance with all federal, state, local and internal policies, and procedure
• Responsible for submitting claims and ensuring follow-up on outstanding claim
• Denial management to ensure an efficient process and ultimately resolution.
• Ensures information obtained is complete and accurate t
• Collaborates with internal departments and external providers on utilization management of authorization
• Ensures up-to-date documentation in billing software
• Performs other duties as assigned with a comprehensive understanding of all functions on the entire revenue cycle

Job Competencies

• Understand essential functions Within the areas of Revenue Cycle Department

Prior Authorization

• Eligibility
• Charge Entry/Billing
• Maintain current knowledge of billing rules for providers (hospital and physicians) and Insurance Providers
• Ability to work with Insurance Providers to drive resolutions via portals and telephone communica

Job Qualifications, Skills, Abilities, Requirements: To perform this job successfully, an individual must be able to perform each essential duty to our current standards and meet the expected KPI’s. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of healthcare billing and reimbursement strategies.
• Ability to effectively communicate both orally and in writing.
• Demonstrates the ability to plan and prioritize work, coordinate with others, use time productively.
• Provide excellent customer service to both internal and external customers.
• Attention to detail is a must for researching and interpretation.
• Ability to support HIPAA privacy rules and maintain strict confidentiality.
• Self-Motivated with the ability to function as a team player and as an individual contributor.
• Ability to adapt to change and be flexible.
• Engages in all time sensitive tasks with level or urgency.
• 2+ years of relevant experience in finance/healthcare, medical billing & reimbursement.
• Experience with State and Federal (Medicare, Medicaid) and private insurance billing portals.
• Proficiency in Microsoft products including Word and Excel.
• Proficient in Epic, Meditech, Salesforce a plus

Earnings

$19.00 hourly

Category

Revenue Cycle