Medical Claims Specialist

  • Company: Adecco
  • Posted: January 21, 2017
  • Reference ID: 1852878826
Adecco is staffing for one of the most leading Healthcare software companies in the industry. As a Collections Specialist, you will be following up with clients for unpaid insurance claims. Please note that other duties may be assigned by your supervisor.
Essential Duties and Responsibilities: Please note that other duties may be assigned by your supervisor.
• Working of aged accounts
• Complex denial research
• Participate in client meetings
• Answer patient, client, or insurance carrier questions regarding claims
• Maintain the strictest confidentiality in accordance with all HIPAA guidelines/regulations
• Stay abreast of code changes, updates to reimbursement guidelines, and coverage policies

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required including computer skills/level.
• Working knowledge of healthcare code sets
• Working knowledge of clean claim practices
• Working knowledge of the adjudication process
• Ability to research and follow claims appeal guidelines/processes
• Understanding of the complete healthcare revenue cycle
• Understanding of provider contracts and credentialing
• Understanding of basic accounting functions
• Proficient in Microsoft Outlook, Word, Excel
• Organized and detail-oriented

Requirements:
• Experience with healthcare billing
• Experience with hospital based follow-up desired
• Working knowledge of the adjudication process
• Understanding of provider contracts and credentialing
• Understanding of the complete healthcare revenue cycle
• Basic accounting functions

Previous experience in a healthcare billing role.
Knowledge of healthcare code sets
Knowledge of clean claim practices
Knowledge of complete healthcare revenue cycle


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