Medical Billing – Revenue Cycle – Commercial Claim Status Specialist - Remote

Global Medical Response • Full-time • West Plains, Missouri, United States • 6m ago

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Medical Billing – Revenue Cycle – Commercial Claim Status Specialist

Remote

Starting Pay $19.00

The Medical Billing Claim Status Specialist 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.

· Other duties as assigned

Education:

· High school diploma or equivalent required

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 (Not Required) 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

EEO Statement

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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