Revenue Cycle Medical Billing IDR Claim Status

Global Medical Response•West Plains, MO

3d•Remote

About The Position

The Revenue Cycle Medical Billing IDR Claim Status Specialist must have experience working with one or multiple payor sources, including Commercial and Blue Cross/ Blue Shield insurances. The successful candidate will have effective communication skills and an eagerness to verify the status of each claim after it has been submitted to insurance. All tasks must be performed in a timely and accurate manner in accordance with billing office practices, policies, and procedures.

Requirements

Must be fluent in English
Minimum of one (1) year of medical billing experience
Professional written and verbal communication skills
Knowledge and experience of computers and related technology
Ability to work independently with little or no direction and as a member of a team
Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards.
Understanding and interpretation of Explanation of Benefits (EOB) from payors
Strong problem-solving skills, attention to detail, and ability to make timely decisions
Excellent internal and external customer service skills
Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision

Nice To Haves

Minimum of one (1) year working in a call center environment
Above average knowledge of insurance billing guidelines and policies
Experience with Commercial Insurance processes and policies is a plus

Responsibilities

Verifies the status of claims that have been billed to insurance on a timely basis according to the productivity guidelines for Claim Status goals.
Makes claim inquiries via online portals, telephone, email, etc., and multitasks on accounts when on-hold over the phone.
Meets daily and monthly departmental production goals set forth by the supervisor to ensure that the company is achieving its financial goals.
Identifies, documents, and communicates trends in recurring rejections and denials to the supervisor.
Recommends process improvements or system edits to eliminate future denials.
Pursues unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow-up timelines.
Documents all account activity in an accurate and timely manner for all touch points made on any patient account.
Contacts patient for additional information when necessary to push the claim through for payment.
Submits requested additional information/documentation at payor request for claims to process accordingly.