What are the responsibilities and job description for the Claims Filing Specialist position at Professional Staffing Services Group?
Claims Filing Specialist
Mon.-Fri. 7am-4pm $18.00 per hr.
Job Summary:
The EDI Claims Filing Specialist ensures the accurate and timely submission of medical claims to payers, both electronically and via paper, while maintaining compliance with all documentation requirements. This role involves troubleshooting claim errors, reconciling data, and adhering to departmental performance metrics.
Responsibilities:
- Prepare and review medical claims, ensuring compliance with departmental policies and procedures for both electronic and paper submissions.
- Correct billing and clearinghouse errors to facilitate successful claim submission.
- Research and resolve payer filing requirements that require additional information, including updating filing methods as needed.
- Perform daily reconciliations to ensure accurate claim tracking across the billing system, work queue system, and clearinghouse.
- Review incoming correspondence and take appropriate action to resolve issues.
- Meet and maintain established departmental performance metrics for productivity and quality.
- Maintain up-to-date knowledge of department workflows, systems, and tools.
- Adhere to the company's Code of Conduct and Mission and Value Statement.
- Perform other duties as assigned.
Qualifications:
- High school diploma or GED preferred.
- Minimum one year of related healthcare experience in medical claims billing (both paper and electronic) strongly preferred.
Knowledge, Skills, and Abilities:
- Communication: Excellent verbal and written communication skills, including proper punctuation and spelling.
- Customer Orientation: Ability to build and maintain positive relationships with internal and external stakeholders, consistently meeting and exceeding expectations.
- Interpersonal Skills: Ability to work effectively with colleagues, patients, and external parties.
- PC Skills: Proficiency in Microsoft Office applications and other relevant software.
- Policies & Procedures: Knowledge and understanding of organizational policies, procedures, and systems.
- Essential Skills: Ability to organize, prioritize, and accurately track multiple tasks within short timeframes; ability to work efficiently and accurately in a fast-paced environment while managing multiple demands; ability to work both independently and collaboratively as a team player; adaptability, analytical and problem-solving skills, and attention to detail; ability to perform basic mathematical calculations, balance and reconcile figures, and transcribe accurately.
Salary : $18
