Job Description
Job Description
Do you have a strong attention to detail? Have you worked in Medical Billing, specifically in claims, denials, and appeals? Our client, a national medical supply company in Glen Allen, is now hiring Medical Claims Credit Reviewers!
Position : Medical Claims Credit Reviewer
Location : Glen Allen, VA
Compensation : Based on experience
Schedule : Monday – Friday, 8 : 00am – 5 : 00pm
POSITION SUMMARY :
Ensures that the company properly reimburses the insurance companies for claims identified as overpayments and assists with identifying trends to determine if a valid credit for refund or a fee schedule variance exists. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and policies.
JOB TASKS / FUNCTIONS :
- Research and resolves overpayments with claims, including refunding and communicating with the insurance companies or customers.
- Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.
- Monitors refunds to ensure properly retracted by payers. If not retracted, the associate must investigate with the payer to determine the root cause.
- Effectively communicates with revenue management staff, including potential changes to PayerPro, changes in fee schedule, etc…
- Performs all other duties as assigned, which may vary at any time with or without notice.
MINIMUM QUALIFICATIONS :
Able to complete tasks in specified time frameDemonstrates strong organization skills and proven ability to multi-task and manage time in order to meet frequently changing deadlines in a fast-paced environmentDemonstrates superior professional ethic and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete securityDemonstrates excellent interpersonal, oral, and written communication skillsDemonstrates excellent organizational skills as well as strong attention to detailDemonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workloadPREFERRED QUALIFICATIONS :
High School Diploma and / or GED requiredAssociate’s degree in general studies, accounting, finance or similar course of studyProficiency in Microsoft Office SuiteProficiency in Claims Management systemsExperience with insurance billing and / or collectionsPHYSICAL REQUIREMENTS :
Ability to sit for extended periods, typically 6-8 hours a day, while working at a computer stationProficiency in using a keyboard, mouse, and other computer peripherals for data entry and communication purposesAbility to view a computer screen for prolonged periods, with good visual acuity to read small print and accurately enter dataAdequate hearing ability, with or without correction, to understand and respond to customer inquiries via telephone or other audio equipmentRegular use of the hands, wrists, and fingers to perform repetitive tasks such as typing and using a mouseWHY WORK FOR QUALIFIED STAFFING?
We offer a fantastic benefits package to all of our employees. This includes healthcare, vacation / holiday pay and 401K! In fact, these are the same benefits that we offer our corporate employees!Applying for one job with Qualified Staffing is like applying for hundreds of jobs all at once!We respond to every job applicant within 24-48 hours.INDRic
