What are the responsibilities and job description for the Claims Analyst position at The Plastic Surgery Center?
About Us:
TPSC, SMM, and TCOPS are members of the Advanced Reconstructive Surgery Alliance (ARSA), one of the largest privately owned groups of Plastic and Reconstructive Surgeons in the country
Advanced Reconstructive Surgery Alliance (ARSA) and its affiliates TPSC, SMM and TCOPS are the largest Plastic Surgery medical practice in the country. Our expanding team of top tier physicians, coupled with our continued medical advancements, allows us to offer patients extraordinary clinical services with a 5-star experience. We have a bold vision with a desire to revolutionize the industry, meeting patient needs while favorably transforming their lives. Common across the enterprise is not only the commitment to providing safe patient care, but to employee satisfaction and growth opportunities. It is a culture of teamwork, respect and appreciation for all employees—whether caring for patients directly or working in a support role.
We are seeking bright, collaborative, motivated and dedicated individuals to join our team. As an employee, you’ll be surrounded by colleagues who go beyond what is expected and look to exceed expectations at every turn. If being part of a fast growing, entrepreneurial thinking surgical practice excites you, look no further!
TPSC is seeking an organized, detail oriented, Claims Analyst who is able to work well independently and collaboratively with our team. The Claims Analyst focuses on the accurate and timely resolution of insurance claims. This includes but is not limited to collection, denials and communicating with insurance carriers, including local and out of state plans, physicians, and management to achieve resolution of issues and expedite claims payment is vital in this position.
Job Responsibilities:
- Become an expert in the claim processing rules and protocols as defined in the Provider Manual of one or more third-party payers.
- Identify and analyze any and all issues hindering the proper payment of claims by third-party payers.
- Monitor and review open Accounts Receivables, adjustments, refunds, and changes.
- Promptly respond to denial letters and requests for information.
- Maintain clear and cohesive notes/documentations/forms related to all open and pending claims being worked.
- Maintain patient and company confidentiality.
- Other responsibilities as assigned.
Job Requirements:
- High School Diploma or equivalent
- 2 years’ experience in medical billing and collections
- Strong working knowledge of both In and Out of Network claims processing
- Knowledge of medical terminology, CPT and ICD Coding and billing forms (HCFA).
- Excellent verbal and written communication skills.
- Excellent organizational and business office skills.
- Ability to work effectively with colleagues within a team-based assignment.
- Must be goal and detail-oriented and able to perform successfully in a fast-paced medical environment.
SMM provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Work Location: In person
