Ap Claims Processor

Lutheran Services Carolinas•Salisbury, NC

2d•Onsite

About The Position

Lutheran Services Carolinas (LSC), a mission-driven nonprofit serving individuals and communities across North and South Carolina, is seeking a full-time Accounts Payable - Claims Processor for its Finance team at the Administration Office. This in-person role ensures paper and electronic claims received from providers are accurately processed and adjudicated according to organizational policies and procedures. The processor verifies Medicare and contracted provider payment rates, communicates with providers to resolve issues, and enters properly adjudicated claims into the accounts payable system. The position is based at LSC's Administration Office and is primarily scheduled Monday through Friday, 8:00 AM to 4:30 PM, with some scheduling flexibility. Compensation is based on experience and skill set. Teammates who opt out of benefits receive an additional $2.00 per hour. Benefits begin after 30 days.

Requirements

High school diploma or equivalent.
Excellent computer skills and proficiency with Microsoft Office.
Strong organizational and time-management skills.
Excellent written and verbal communication skills.
Ability to work effectively with providers and internal teammates to resolve claims and billing issues.
Strong attention to detail and accuracy.
Excellent interpersonal skills.
Strong data entry skills.
Ability to appropriately manage confidential and proprietary information.

Nice To Haves

Bachelor's degree.
Previous experience in accounts payable and/or claims processing.

Responsibilities

Follow established procedures to pay, return, or deny claims and verify that payments have been completed.
Review and resolve claims discrepancies in a timely manner.
Develop effective working relationships with billing providers, members, and internal teammates.
Review authorization documentation, determine applicable benefits, and initiate appropriate denial or payment processes.
Work with billing providers and interdisciplinary teams to correct claim authorizations and ensure claims can be processed appropriately.
Research and process claims according to business regulations, internal standards, and processing guidelines.
Verify procedure and diagnosis coding for claims.
Research and resolve system edits, audits, and claims errors using approved references and investigative resources.
Coordinate with internal departments to resolve edits and deferrals and update patient, insurance, provider, and related records as needed.
Process payment for properly adjudicated claims.
Maintain accurate and organized claims files.
Record 1099 forms each calendar year.
Perform other duties as assigned.