Claims Specialist

  • location: Atlanta, GA
  • type: Contract
  • salary: $17.56 per hour
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job description

Claims Specialist

job summary:
Our Client is Hiring!

Job Description:

Summary:

The main function of the claims specialist is to analyzing claim denials, working with payors to resolve denials, tracking all denials by payor and denial category, trending recurring denials, and recommending process improvement or system edits to eliminate future denials.

Job Responsibilities:

  • Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement.
  • Receives denied claims and researches appropriate appeal steps. Collect required documentation, review file documentation, and make sure all items needed are requested.
  • Ensure that all claim documentation is complete, accurate, and complies with company policy.
  • Establish, maintain, and update files, databases, records, and other documents for recurring internal reports.
  • Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.
Skills:

  • Basic knowledge in lending and the real estate industry.
  • Excellent written and verbal communication.
  • Strong attention to detail.
  • Ability to handle multiple tasks with frequent interruptions.
  • Knowledge of basic accounting processes and procedures.
  • Basic computer skills including Microsoft Office.
Education/Experience:

  • Associate's degree in billing, coding, business, finance or related field required; equivalent work experience may be substituted for education 5 to 7 years of experience required.
 
location: Atlanta, Georgia
job type: Contract
work hours: 8 to 5
education: Bachelor's degree
experience: 2 Years
 
responsibilities:
Job Description:

Summary:

The main function of the claims specialist is to analyzing claim denials, working with payors to resolve denials, tracking all denials by payor and denial category, trending recurring denials, and recommending process improvement or system edits to eliminate future denials.

Job Responsibilities:

  • Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement.
  • Receives denied claims and researches appropriate appeal steps. Collect required documentation, review file documentation, and make sure all items needed are requested.
  • Ensure that all claim documentation is complete, accurate, and complies with company policy.
  • Establish, maintain, and update files, databases, records, and other documents for recurring internal reports.
  • Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.
Skills:

  • Basic knowledge in lending and the real estate industry.
  • Excellent written and verbal communication.
  • Strong attention to detail.
  • Ability to handle multiple tasks with frequent interruptions.
  • Knowledge of basic accounting processes and procedures.
  • Basic computer skills including Microsoft Office.
 
qualifications:
Education/Experience:

  • Associate's degree in billing, coding, business, finance or related field required; equivalent work experience may be substituted for education 5 to 7 years of experience required.
Required Skills:

Working in the Emergency Department of a hospital collecting on patient responsibility for visit; Possess and apply thorough knowledge of collections and the ability to apply the knowledge to all aspects of patient account including insurance, billing, and collection processes; Identify problem accounts and reviews accounts for discrepancies and potential issues; Contact insurance companies to resolve patient responsibility at point of service; May make recommendations to Manager on proper course of action to collect on account; Sort and file correspondence.

This position is ON-SITE in the ER department of a hospital.

 
skills: Other
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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