Required Education and Experience : High School graduate or equivalent. 2-4 years in a medical business office or related field.
Experience with the claims adjudication process for multiple governmental agencies and private insurance carriers. Basic medical terminology.
Current CPT and ICD-10 coding experience.
Additional Eligibility Qualifications : Ability to assist new hires and others in detailed training processes. An aptitude to retain detailed information.
Ability to be multi-tasked oriented, to prioritize and to produce an acceptable volume of work. Excellent organizational and problem-solving skills.
Excellent communication skills, oral and written. Basic knowledge of Windows-base computer applications. Accurate typing rate of 40 wpm.
Ability to operate the following equipment : computer, copier, fax, web based payer sites, and 10-key calculator.
Essential Functions
Follows up on open claims in accordance with established guidelines. Reviews claims for completeness and compliance with billing guidelines.
Works to resolution disputes of third-party denials. Contests charges that are not paid or underpaid with the carrier. Accesses available third party and governmental on-line services.
Documents all actions within the system.
Possesses a comprehensive understanding of Clinic contracts, carrier specific, State or Federal governmental, HCFA, or CPT billing and reimbursement guidelines.
Reviews bulletins, updates, etc., and maintains as reference / resource material.
Possesses a comprehensive understanding of how to enter insurance information into the billing system. Remain current on new FSC’s that are created and understand how they are used.
Reviews and edits registration information according to clinic policy.
Cross train in all areas within the Insurance Department. Assist Supervisor in the education of new employees, the monitoring of staff and workflow in all areas of claims processing and payment posting within the Insurance Department.
Accesses available third-party and government on-line services. Accesses appropriate websites to obtain current carrier guidelines, verify eligibility and re-files claims if necessary.
Special Accounts Representative II - Insurance Follow up - Full Time
Follows up on open claims in accordance with established guidelines. Assist Supervisor in the education of new employees, the monitoring of staff and workflow in all areas of claims processing and payment posting within the Insurance Department. Experience with the claims adjudication process for mu...
Data Engineer II-Full Time
Build and maintain batch and real-time data pipelines. Build end-to-end processes supporting data ingestion, data transformations, data wrangling, data cleansing and data delivery. ...
Ultrasonographer II - Full Time
ARDMS registered, possess the ability to do duplex scanning, one year of experience in ob, Gyn, or Abd. ...
Life Insurance Sales Representative - Remote | Full Training Provided
Launch Your Career in Life Insurance Sales - Unlimited Income Potential! 🌟 Are you passionate about helping families secure their financial future? Join our growing team of insurance professionals and build a rewarding career protecting what matters most! 💼 What Makes This Opportunit...
Accounts Payable / Receivable & Special Projects Administrative Representative
Works multiple priority activities concurrently that require extensive coordination with multiple managers, time zones, and follow-through. Proactively support a wide range administrative duties and processes. Proactively support of a wide range financial activities including, but not limited to, AP...
Medical Coder II - Full Time
Good problem solving skills and the ability to communicate clearly in writing and verbally to assigned providers and support staff. Stays informed and up to date on coding issues by attending seminars. ...
Sales Representative (Part Time/Full-Time) - Windsor, ON
As a Financial Sales Representative, you will be educating and offering Financial Products on behalf of one of the most trusted and iconic Canadian brands. Fully paid training and ongoing coaching . ...
Personal Lines Sales Agent – Full-Time
Langley is looking for Full Time – Personal Lines Sales Agents. ...
Full Time Street Fundraiser
Ability to engage and motivate others A focused mindset with a passionate drive A passion for leading from the frontlines and fundraising to achieve personal donor targets Someone who wants to advance in their fundraising career *Apply today to join our team at UP* Curious to learn more...
Customer Services Representative - Delta Branch - 6-month full-time
While this job is posted as a Customer Service Representative, internally, we title it a Member Service Representative, always putting members at the centre of everything we do. To be successful as a Member Service Representative in a Coast Capital branch, you must be positive, team-oriented individ...