Accounts Receivable Medical Specialist-Claims

TEKsystems
$20.00 / hr

Nov 22, 2024
Description: For now this position will last until the end of December but could get extended. Contract role sitting onsite in Rochester Hills, MI Monday- Friday 8am-4:30pm during training and after training the hours are flexible from 7am- 5pm as long as you get 40 hours- 30 min lunch You will pull claims, review them to see where they are at in the process, have they been paid, is there an error (missing modifiers, wrong name, prescriptions not attached) then will fix the basic errors and resubmit the claim to the payer. Will be required to pull claims, print claims, fax claims as necessary. Will be reaching out to the insurance companies to figure out what errors have occurred if it is not stated. Will not be talking to patients or doing collections from patients, all efforts will be geared towards the payers. To be successful in this role a candidates must understand EOB's and be familiar with medical claims to be able to recognize what is missing and the terminology that the team is using. Essential Duties and Responsibilities: Process daily tasks assigned from the billing software system. Enter and process data related to patient care and reimbursement. Check to ensure all patient documents are on file and completed correctly. Connect with insurance payors by telephone or online regarding non-payment or short payment on outstanding claims. Respond to insurance payor correspondence. Review and resubmit simple corrections to low dollar claims to payors for reprocessing. Work AR aging reports for payors. Review claims forms to primary, secondary, and tertiary insurance payors as needed. Work accounts promptly to ensure claims are processed appropriately. Provide exceptional customer service to all internal and external customers. Review HCPC, modifiers, and ICD-10 codes for accuracy while keeping up with compliance and coverage criteria to update employees as needed. Meets work standards by following productivity, quality, and customer service standards established by the company. Complies with Corporate Compliance and HIPAA responsibilities. Perform other duties and special projects as assigned. Knowledge, Skills, and Abilities:* Experience with HCPC, ICD-10 medical terminology, accounts receivable, insurance collections and payor requirements, or billing. Ability to work quickly and accurately and pay attention to detail. Proficient with Microsoft Office Software- Excel, Word and Outlook and databases. Strong data entry skills. Ability to work in a fast-paced environment. Communicate clearly, both verbally and in writing, with clinical and non-clinical personnel, patients, and care givers in a professional and respectful manner. Demonstrate organizational, analytical, and time management skills. Dependable, reliable, and punctual. Minimum Qualifications - (Education, Experience, Certification, & Licensure): High school diploma or equivalent qualification required. Minimum 1 year of experience in accounts receivable, claims, and insurance payor requirements. Familiarity of Medicare and Medicaid preferred. Knowledge of Orthotics, Prosthetics, and DME a plus preferred. Skills: medical claim, modifiers, Explanation of benefits, payers, insurance providers, insurance claim, dme, orthopedic, orthotics, medicare claims, medicaid programs Top Skills Details: medical claim,modifiers,Explanation of benefits,payers,insurance providers,insurance claim Additional Skills & Qualifications: Minimum Qualifications - (Education, Experience, Certification, & Licensure): High school diploma or equivalent qualification required. Minimum 1 year of experience in accounts receivable, claims, and insurance payor requirements. Familiarity of Medicare and Medicaid preferred. Knowledge of Orthotics, Prosthetics, and DME a plus preferred. Experience Level: Entry Level send resume' to kvanduren @teksystems.com About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.