Overview:
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Responsibilities:
Revenue Cycle Medical Billing - Commercial Claim Status Representative
Work Location: On-Site or Remote
Work Schedule: Full-Time
Hourly Pay: $19
The Revenue Cycle Medical Billing Claim Status Representative must have experience working with one or multiple payer sources, such as to include Commercial and Blue Cross/ Blue Shield insurances. The successful candidate will have effective communication skills and an eagerness to verify the status of each claim after it has been submitted to insurance. All tasks must be performed in a timely and accurate manner in accordance with Billing Office practices, policies, and procedures.
Essential Functions/Duties
Verifies the status of claims that have been billed to insurance on a timely basis according to the productivity guidelines for Claim Status goals.
Makes claim inquiries via online portals, telephone, email, etc. and multitasks on accounts when holding over the phone.
Meets daily and monthly departmental production goals set forth by the Supervisor to ensure that the company is achieving its financial goals.
Identifies, documents, and communicates trends in recurring rejections and denials to Supervisor.
Recommends process improvements or system edits to eliminate future denials.
Pursues unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow-up timelines.
Comprehensively documents all account activity in an accurate and timely manner for all touches made on any patient account.
Contact patient for additional information when necessary to push the claim through for payment.
Submit requested additional information/documentation at payor request for claims to process accordingly.
Skills:
Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards
Understanding and interpretation of Explanation of Benefits (EOB) from payors
Strong problem-solving skills, attention to detail, and ability to make timely decisions
Excellent internal and external customer service skills
Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision
Qualifications:
Required Experience
Must be fluent in English
Minimum of one (1) year of medical billing experience
Professional written and verbal communication skills
Knowledge and experience of computers and related technology
Ability to work independently with little or no direction and as a member of a team
Preferred Experience
Minimum of one (1) year working in a call center environment
Above average knowledge of insurance billing guidelines and policies
Experience with Commercial Insurance processes and policies is a plus
Preferred Education
High school diploma, GED, or equivelant in relevant work expereience
Why Choose GMR? Global Medical Response (GMR) and its family of solutions are dedicated to delivering compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. Here you'll embark in meaningful work that will make an impact on you and the customers we serve. View our employees' stories on how we provide care to the world at www.AtaMomentsNotice.com.
Qualifications:
Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
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