Claims Representative Job Plymouth Meeting Pennsylvania USA,Healthcare

Location: Plymouth Meeting

Hiring Incentive

Mid Atlantic Retina’s $1,000 Hiring Incentive! The hired candidate will receive $500 after successful completion of 90 days of employment and $500 after successful completion of 1 year of employment. Available to new hires only – not available to agency hires, internal transfers, or re-hires.

Sign-on Bonus

Yes

Job Type

Full Time

Qualifications

3-5 years medical billing experience in a physician practice or third-party billing company preferred
Previous experience with claims processing and working with a clearinghouse
Experience with CPT, ICD
10, and Microsoft Office Suite required

Job Description

The Claims Representative is responsible for submitting both electronic and paper claims to insurance companies. This position ensures that all accounts are billed appropriately and meet all regulatory and compliance requirements. The Claims Representative is also responsible for reviewing daily claim edit reports and working with other departments to resolve the claim edits.

Essential Functions

Pulls daily Claim Edit report from Nextgen to review red edits for errors

Collaborates with Front Desk and Clinic to correct errors

Submits corrected report through clearinghouse via EDI file or uploading

Complete paper claims by reviewing account, attaching needed information, and mailing out to responsible payer

Ensures correct processing of all accounts

Acts as customer service representative in person and by telephone. Promptly responds to patient and corresponding payor questions regarding accounts

Maintains up to date billing knowledge of insurance carriers to act as a resource for other departments within MAR

Attends regular staff meetings

Works overtime as needed

Travels to other MAR locations as needed

Performs other duties as assigned

Benefits

Health Insurance
Dental Insurance
Vision Insurance
Paid Sick Time
Paid Vacation Time
Company Bonuses twice a year (after 1 year of employment)
7 Paid Company Holidays
401K
Profit Sharing
Company Paid Life Insurance

Physical and Cognitive Demands

This is largely a sedentary role; however, some filing may be required. This would require the ability to occasionally lift files, bend, stoop, crouch, reach, and stand on a stool as necessary.

Ability to lift or move up to 15 pounds at times.

Work with data by calculating and manipulating numbers, processing data on a computer, classify, record, store and retrieve information.

Use words to communicate ideas, read with comprehension and explain abstract or complex ideas in more basic terms.

The employee will use hands to operate equipment such as a computer mouse, show manual or finger dexterity, handle things with precision or speed, use muscular coordination and physical stamina.

While performing the duties of this job, the employee is regularly required to talk, communicate verbally one to one, in front of groups, over the telephone or with a headset and in email.

This position requires listening to verbal communication using a telephone or with a headset and processing the information while entering the data into a computer system, processing auditory information, and responding verbally back in an appropriate manner.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus with or without corrective lenses.

Ability to follow through on plans or instructions.

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