Revenue Cycle Medical Billing IDR Claim Status Representative

US-MO-West Plains

Field Careers

Req #: 53272
Type: Regular Full-Time
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Global Medical Response

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				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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