Claims Specialist-Journal Center

Schedule

Monday-Friday 0800 - 1230 w/ 30 min lunch and other shifts as needed.

Journal Center

Hourly Position

Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge to's, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports.

• Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration.
• Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration.
• Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days.
• Researches adjustments and pull all necessary backup to support adjustments.
• Utilizes on-line insurance resources to obtain and maintain current information.
• Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives.
• Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate.
• Customizes reports in Antrim and or Excel to prioritize accounts for collecting.

High school diploma or equivalent

• Six (6) months as an Apprentice in the Business Office at Tri Core
• Minimum of one (1) year of laboratory or medical claims follow-up/collections experience
• Minimum of three (3) years of medical billing or claims processing experience

• Must be able to type 30 words per minute (typing test required)
• Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications

• Basic knowledge of Excel and Word Knowledge of medical terminology

Prove immunity to Hepatitis B or be immunized or sign a waiver refusing hepatitis immunization. Provide documentation of a PPD test conducted not more than 90 days prior to date of hire or have a PPD test conducted.

• Proficient in PC/data entry skills
• Must be able to work independently with little direction and to demonstrate sound judgment and problem solving skills
• Ability to resolve problems and follow up as needed or appropriate
• Effective communication skills and telephone skills
• Ability to deal with difficult clients and patients
• Strong working knowledge of insurance and reimbursement