AR Claims Specialist I
About The Position
Join our team as an AR Claims Specialist I at our Administration South in Toppenish, WA! Be part of a healthcare organization that believes in making a difference beyond medical care! We've transformed into a leading community health center in the Pacific Northwest with 40+ clinics across Washington and Oregon. We offer a wide range of services such as medical, dental, pharmacy, orthodontia, nutritional counseling, autism screening, and behavioral health. Our holistic model also extends assistance to shelter, energy, weatherization, HIV and AIDS counseling, home visits, and mobile medical/dental clinics. Explore our short clips, "WE are Yakima - WE are Family" and "YVFWC - And then we grew," for a glimpse into our dedication to our communities, health, and families. Visit our website at www.yvfwc.com to learn more about our organization. Position Highlights: $19.76-$24.21/hour DOE with the ability to go higher for highly experienced candidates 100% employer-paid health insurance including medical, dental, vision, Rx, and 24/7 telemedicine Profit sharing & 403(b) retirement plan available Generous PTO, 8 paid holidays, and much more! What You’ll Do: Prepare and process insurance claims timely and accurately to government, commercial and managed care payers Review, submit and/or distribute corrected claims Enter appropriate account notes in Epic billing system to clarify actions taken to reconcile claims Resolve claim edits daily via claim edit work queues and/or our external billing software Verify eligibility for coverage via multiple payor websites Assure compliance with billing requirements for workers compensation and third-party liability claims Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information Maintain confidentiality of all patient demographics, medical and financial information at all times. Mains Epic Claims Workqueues to department daily standard. Maintain daily balance logs of claims sent from EMR to Clearinghouse daily to ensure all claim runs are balanced daily. Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.
Requirements
- High School diploma or General Education Diploma (GED).
- Minimum six months experience in healthcare setting.
- Strong attention to detail and accuracy.
- Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500)
- Maintain consistent performance and attendance standards
- Effective verbal, written and listening communication skills are essential.
Nice To Haves
- FQHC Billing or Coding and Epic system experience is preferred.
- Certified Revenue Cycle Representative (CRCR) Preferred
- Strong customer relations skills preferred
- Knowledge of medical/dental terminology, data entry, and billing coding preferred.
- Knowledge of accounts receivable processes preferred.
Responsibilities
- Prepare and process insurance claims timely and accurately to government, commercial and managed care payers
- Review, submit and/or distribute corrected claims
- Enter appropriate account notes in Epic billing system to clarify actions taken to reconcile claims
- Resolve claim edits daily via claim edit work queues and/or our external billing software
- Verify eligibility for coverage via multiple payor websites
- Assure compliance with billing requirements for workers compensation and third-party liability claims
- Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information
- Maintain confidentiality of all patient demographics, medical and financial information at all times.
- Mains Epic Claims Workqueues to department daily standard.
- Maintain daily balance logs of claims sent from EMR to Clearinghouse daily to ensure all claim runs are balanced daily.
- Other duties as assigned.
Benefits
- 100% employer-paid health insurance including medical, dental, vision, Rx, and 24/7 telemedicine
- Profit sharing & 403(b) retirement plan available
- Generous PTO, 8 paid holidays, and much more!
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
