Medical Claims Processor (Must have medical claims exp.-Remote role)
Company: Jobot
Location: Raleigh
Posted on: May 16, 2022
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Job Description:
If you are a medical claims guru, I need you This Jobot Job is
hosted by Dana Stark Are you a fit? Easy Apply now by clicking the
"Apply" button and sending us your resume. A Bit About Us Our
services target the $2.8 trillion in US healthcare spending using
our healthcare transparency tools. Why join us? Working within our
fast growing Healthcare Technology organization, you could become
one of our ambitious Patient Advocates with a focus on
Reference-Based Pricing (RBP). Job Details Working within our fast
growing Healthcare Technology organization, you could become one of
our ambitious Patient Advocates with a focus on Reference-Based
Pricing (RBP). Our services target the $2.8 trillion in US
healthcare spending using our healthcare transparency tools.
Primary Purpose The Patient Advocate is responsible for handling
member, client and provider inquiries (Balance Bills and appeals)
based upon an assigned client base. This person is also responsible
for addressing member calls related to balance billing situations,
educating of the process and negotiations for closing out the
balance bills. The Patient Advocate is experienced and highly
skilled in working with facilities, providers through negotiations
and helping guide patients related to balance billing claim issues
. Core Responsibilities Manages facility, provider and member
inquiries, appeals and balance billing; including correspondence.
Reviews and resolves balance bills and appeals with providers;
through negotiations. Identifies troubled facilities for potential
direct contracting and redirection. Ensures clear documentation of
events associated to a claim resolution. Provides updates and
solicits required information from clients as needed. Keeps direct
report informed of critical matters that impact responding timely
to appeals/balance bills. Manages a daily running inventory of
claims, prioritizing one---s work schedule accordingly. Addresses
emails and incoming calls. Ensures member inquiries are addressed
timely; including education. Participates in on-going process
improvement to develop efficiencies that streamline the process and
the Patient Advocacy Center. Assists in maintaining a clean, safe
and unobstructed workplace environment. These duties are not
exclusive and with consideration of your job requirements and other
skills, this job description can be added to or taken away from at
the discretion of your immediate supervisor. Qualifications
Baccalaureate degree (BA/BS) from an accredited college or
university preferred Experience in a medical healthcare claims role
dealing with facilities, providers and members is Required
Background in healthcare claims management environment including
provider hospital billing, claims adjudication and administration
or the ability to interpret benefit plans/Explanation of Benefits
This role necessitates a proactive, self-starter Possesses
exceptional multi-tasking and strong communication skills, both
oral and written A high level of professionalism, organization and
flexibility Excellent written, verbal, and interpersonal
communication skills Excellent organizational skills demonstrating
strong attention to detail Ability to manage high call volume
Ability to multi-task effectively Should possess a moderate to high
level of claim editing, coding, RVU and CMS-based pricing knowledge
with an emphasis in researching solutions for the above items as
needed Bilingual preferred PC literate, including Microsoft Office
products and web-based applications Regular, timely attendance
Interested in hearing more? Easy Apply now by clicking the "Apply"
button.
Keywords: Jobot, Raleigh , Medical Claims Processor (Must have medical claims exp.-Remote role), Healthcare , Raleigh, North Carolina
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