Medical Claims Representative
This job is no longer active.
View similar jobs.
POST DATE 1/16/2020
END DATE 2/1/2020
JOB DESCRIPTIONAdvanced Resources has an immediate opening for a Medical Claims Representative in Downtown Chicago. The successful candidate will have experience in medical claims, denials and existing relationships with payers for effective resolution. Apply Now!
* Review payer balances in Electronic Health Record, and document follow-up progress. Aggressively pursue insurance companies 30 days past due
* Follow up on denials by directly contacting insurance payers to understand what is needed to process and reimburse all outstanding claims and work with programs to make the necessary changes to ensure issues are resolved prior to timely filing limits
* Troubleshoot and Research claims and re-billing if necessary; including appealing denials or incorrectly paid claims.
* Monitor and Report on Payer's status on a regular basis
* Work with payers and program staff to ensure proper authorizations for services are provided
* Generate reports on what is outstanding for each payor and what the denial reasons are.
* Capture and report trends
* Works collaboratively and/or coordinates with staff in programs to resolve billing issues.
* Ability to perform arithmetic calculations associated with payments from Clients, including co-payments, coinsurance, & deductible and reconciles payments to client accounts.
* Ability to utilize medical billing software and financial ledgers.
* Ability to manage time efficiently.
* Enters approved write-offs and reports on charity care, bad debt and denial write-off's.
It is Advanced Group's practice not to discriminate against any employee or applicant because of sex, race, color, age, national origin, religion, gender identity or expression, sexual orientation or sexual preference, pregnancy or maternity, genetic information, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law. If you have a disability or handicap and would like us to accommodate you in any reasonable way, please inform your recruiter so that we can discuss the appropriate alternatives available.