QUALIFICATIONS

• 2-3 years of experience, preferred
• High School Diploma, GED or equivalent work experience, preferred

RESPONSIBILITIES

• Processes claims: investigates insurance claims; and properly resolves by follow-up & disposition.
• Verifies patient eligibility with secondary insurance company when necessary.
• Bills supplemental insurances including all Medicaid states on paper and online.
• Mails all paper claims.
• Acts as a subject matter expert in claims processing.
• Manages billing queue as assigned in the appropriate system.
• Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement.
• Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy.
• More challenging claim cases
• Investigates and updates the system with all information received from secondary insurance companies.
• Ensures that all information given by representatives is accurate by cross referencing with the patient’s account, followed by using honest judgement in any changes that may need to be made.
• Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.
• Updates patient files for insurance information, Medicare status, and other changes as necessary or required.
• Keeps email inbox requests up to date at all times; checks for new messages on an hourly basis.
• Mentors new hires; assists
• Assists management and team lead with motivating and coaching employees to succeed as needed.
• Maintains accurate and detailed notes in the company system.
• Adapts quickly to frequent process changes and improvements.
• Is reliable, engaged, and provides feedback as to improve processes and policies.
• Attends all department, team, and weekly company meetings as required.
• Appropriately routes incoming calls when necessary.
• Meets company quality Meets patient service quality standards.

Contracts and Billing is responsible for finance related activities such as customer and vendor contract administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating customer and group purchasing contracts.

• Demonstrates knowledge of financial processes, systems, controls, and work streams.
• Demonstrates experience working collaboratively in a finance environment coupled with strong internal controls.
• Possesses understanding of service level goals and objectives when providing customer support.
• Demonstrates ability to respond to non-standard requests from vendors and customers.
• Possesses strong organizational skills and prioritizes getting the right things done