TEKsystems
Medical Claims Specialist
TEKsystems, Rochester, Michigan, us, 48308
Description
For now this position will start as contract through January - but could get extended. Contract role sitting onsite in Rochester Hills, MI
Monday- Friday 8am-4:30pm during training and after training the hours are flexible from 7am- 5pm as long as they get 40 hours- 30 min lunch
They will pull claims, review them to see where they are at in the process, have they been paid, is there an error (missing modifiers, wrong name, prescriptions not attached) they will fix the basic errors and resubmit the claim to the payer. They will be required to pull claims, print claims, fax claims as necessary. They will be reaching out to the insurance companies to figure out what errors have occurred if it is not stated. They will not be talking to patients or doing collections from patients, all efforts will be geared towards the payers.
To be successful in this role a candidates must understand EOB's and be familiar with medical claims to be able to recognize what is missing and the terminology that the team is using.
Essential Duties and Responsibilities:
• Process daily tasks assigned from the billing software system.
• Enter and process data related to patient care and reimbursement.
• Check to ensure all patient documents are on file and completed correctly.
• Connect with insurance payors by telephone or online regarding non-payment or short payment on outstanding claims. Respond to insurance payor correspondence.
• Review and resubmit simple corrections to low dollar claims to payors for reprocessing.
• Work AR aging reports for payors.
• Review claims forms to primary, secondary, and tertiary insurance payors as needed.
• Work accounts promptly to ensure claims are processed appropriately.
• Provide exceptional customer service to all internal and external customers.
• Review HCPC, modifiers, and ICD-10 codes for accuracy while keeping up with compliance and coverage criteria to update employees as needed.
• Meets work standards by following productivity, quality, and customer service standards established by the company.
• Complies with Corporate Compliance and HIPAA responsibilities.
• Perform other duties and special projects as assigned.
Knowledge, Skills, and Abilities:
• Experience with HCPC, ICD-10 medical terminology, accounts receivable, insurance collections and payor requirements, or billing.
• Ability to work quickly and accurately and pay attention to detail.
• Proficient with Microsoft Office Software- Excel, Word and Outlook and databases.
• Strong data entry skills.
• Ability to work in a fast-paced environment.
• Communicate clearly, both verbally and in writing, with clinical and non-clinical personnel, patients, and care givers in a professional and respectful manner.
• Demonstrate organizational, analytical, and time management skills.
• Dependable, reliable, and punctual.
Minimum Qualifications – (Education, Experience, Certification, & Licensure):
• High school diploma or equivalent qualification required.
• Minimum 1 year of experience handling medical claims denials or rejections within a medical setting.
• Familiarity of Medicare and Medicaid preferred.
• Knowledge of Orthotics, Prosthetics, and DME a plus preferred.
Pay and Benefits
The pay range for this position is $20.00 - $20.00/hr.
• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Rochester Hills,MI.
Application Deadline
This position will be accepting applications until Dec 6, 2024.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
For now this position will start as contract through January - but could get extended. Contract role sitting onsite in Rochester Hills, MI
Monday- Friday 8am-4:30pm during training and after training the hours are flexible from 7am- 5pm as long as they get 40 hours- 30 min lunch
They will pull claims, review them to see where they are at in the process, have they been paid, is there an error (missing modifiers, wrong name, prescriptions not attached) they will fix the basic errors and resubmit the claim to the payer. They will be required to pull claims, print claims, fax claims as necessary. They will be reaching out to the insurance companies to figure out what errors have occurred if it is not stated. They will not be talking to patients or doing collections from patients, all efforts will be geared towards the payers.
To be successful in this role a candidates must understand EOB's and be familiar with medical claims to be able to recognize what is missing and the terminology that the team is using.
Essential Duties and Responsibilities:
• Process daily tasks assigned from the billing software system.
• Enter and process data related to patient care and reimbursement.
• Check to ensure all patient documents are on file and completed correctly.
• Connect with insurance payors by telephone or online regarding non-payment or short payment on outstanding claims. Respond to insurance payor correspondence.
• Review and resubmit simple corrections to low dollar claims to payors for reprocessing.
• Work AR aging reports for payors.
• Review claims forms to primary, secondary, and tertiary insurance payors as needed.
• Work accounts promptly to ensure claims are processed appropriately.
• Provide exceptional customer service to all internal and external customers.
• Review HCPC, modifiers, and ICD-10 codes for accuracy while keeping up with compliance and coverage criteria to update employees as needed.
• Meets work standards by following productivity, quality, and customer service standards established by the company.
• Complies with Corporate Compliance and HIPAA responsibilities.
• Perform other duties and special projects as assigned.
Knowledge, Skills, and Abilities:
• Experience with HCPC, ICD-10 medical terminology, accounts receivable, insurance collections and payor requirements, or billing.
• Ability to work quickly and accurately and pay attention to detail.
• Proficient with Microsoft Office Software- Excel, Word and Outlook and databases.
• Strong data entry skills.
• Ability to work in a fast-paced environment.
• Communicate clearly, both verbally and in writing, with clinical and non-clinical personnel, patients, and care givers in a professional and respectful manner.
• Demonstrate organizational, analytical, and time management skills.
• Dependable, reliable, and punctual.
Minimum Qualifications – (Education, Experience, Certification, & Licensure):
• High school diploma or equivalent qualification required.
• Minimum 1 year of experience handling medical claims denials or rejections within a medical setting.
• Familiarity of Medicare and Medicaid preferred.
• Knowledge of Orthotics, Prosthetics, and DME a plus preferred.
Pay and Benefits
The pay range for this position is $20.00 - $20.00/hr.
• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Rochester Hills,MI.
Application Deadline
This position will be accepting applications until Dec 6, 2024.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.