Claims Management Specialist

UMC Health System•Richmond, KY

5d•Onsite

About The Position

This position requires the ability to communicate both verbally and in writing. Key skills include mainframe computer proficiency, basic accounting knowledge, detailed clerical skills, and strong customer relation skills. The candidate will be responsible for managing accounts in accordance with third-party payer rules and regulations, and must possess an understanding of medical and third-party payer terminology.

Requirements

Ability to communicate both verbally and in writing
Mainframe computer skills
Basic accounting skills
Detailed clerical skills
Good customer relation skills
Manage accounts according to third party payer rules and regulations
Understanding of medical and third party payer terminology
Highly technical
Troubleshooting skills

Responsibilities

Process claim production queues appropriately
Review claim production reports and claim production edit reports
Understand payer specific requirements for electronic and paper claim submission
Document accurately on visits in IDX to convey the billing issue for correction.
Take corrective action when errors are noted on claims
Review payer confirmation reports to ensure all transmitted claims were received by payers
Review paper claims to ensure that affected claims cannot be submitted electronically
Work hold bills assigned by supervisor
Communicates effectively with supervisor and staff to reduce the number of recurring claim errors
Audits the payer table within Click-On to ensure that claims are submitted to the correct payers