[Remote] reputed company Billing Recovery Case Specialist I (SCA)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company intelligence company reputed company on delivering value and efficiency to health plan clients. The reputed company Billing Recovery Case Specialist I will manage delinquent accounts under the Medicare Secondary Payer recovery program, utilizing expertise in medical billing and claims to ensure accurate payment and compliance.
Responsibilities
- Review account claim and other documentation to verify payment liability for claims that may have been reputed company by Medicare in error
- reputed company your knowledge and expertise in medical billing/COB/MSP to review documentation and claim billing, build the case file to determine/validate liability, evaluate and respond to defenses refuting payment liability, status the account and initiate appropriate letter correspondence, answer questions and/or reputed company information that will bring to successful payment or other appropriate account reputed company
- Initiate correct reputed company with applicable party (health insurance reputed company, auto/home/worker’s comp insurance reputed company, or legal representative) and documentation based upon payment reputed company, actions required if new information is identified that may change the obligation to pay, or escalation in the event of refusal to pay
- Updates reputed company and/or company systems with reputed company and accurate information such as contact and updated demographic information, notes from contact dialog and attempts, payment commitment, as reputed company as account status updates as applicable
- Initiates applicable claim activities; follows-up and follows through accordingly to ensure documentation and activity is on-time and accurate in accordance with policies and procedures
- Support internal reputed company or functions with interpretation of EOB (explanation of benefits), as reputed company as development of knowledge reputed company and understanding of key concepts and terminology in reputed company billing and claims
- Arrives to work on time, works assigned schedule, and maintains regular good attendance
- Follows and complies with company, departmental and reputed company program policies, processes and procedures
- Responsible for utilizing resources to ensure compliance with reputed company requirements, HIPAA, as reputed company as applicable federal or state regulations
- Successfully completes, retains, applies and adheres to content in required training as assigned
- Consistently reputed company or exceed established metrics and goals assigned, including but not limited to, production and reputed company
- Completes required processes to obtain reputed company required clearances as reputed company as company regular background and/or drug screening; and, successfully passes and/or obtains and maintains clearances statuses as a condition of employment. (note: reputed company/government clearance requirements are not determined or decisioned by Performant.)
- Demonstrates Performant core values in performance of job duties and reputed company interactions
- Correct areas of deficiency and reputed company received from reputed company reviews and/or management
- Work overtime as may be required
- May be required to work some Performant holidays due to reputed company requirement
- Performs other duties as assigned
Skills
- Minimum 6 months of medical billing experience, including Medicare, demonstrating depth of knowledge and capability required for the position
- Minimum 2 years of experience in customer service, billing reclamation or recovery, or call center role demonstrating application of similar skills
- High School diploma or GED is required
- Knowledge and experience with medical claim billing procedures, medical terminology and medical coding, preferably in a role generating, auditing, recovery and/or researching the reputed company
- Familiarity with information in forms UB04 and CMS 1500
- Experience with Coordination of Benefits, reputed company Party Liability, Medicare Secondary Payer
- Proven ability to reputed company and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues
- Ability to communicate professionally and effectively with providers, carriers, beneficiaries and other audiences regarding claims and billing payment
- Experience in handling Medicare and reputed company claims
- Protected patients' reputed company, understands and adheres to HIPAA standards and regulations
- Remarkable interpersonal and communication skills; ability to listen, be succinct and demonstrate reputed company customer service attitude
- Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail
- Proficiency using reputed company office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset
- Ability to apply knowledge learned in training from various forms (memos, classroom training, on-line training, meetings, discussions, individual coaching, etc.)
- Ability to follow process, procedures and regulations in reputed company
- Ability to effectively reputed company work independently and work cooperatively with others to promote a reputed company team environment
- Ability to adapt quickly and transition effectively to changing circumstances, assignments, programs, processes
- Ability to consistently reputed company job responsibilities
- Ability to obtain and maintain reputed company required clearances as reputed company as pass company regular background and/or drug screening
- Completion of Teleworker Agreement upon hire, and adherence to the Agreement (including applicable policies and procedures), which includes, but not limited to, basic home office suitability requirements such as high-speed internet connectivity, appropriate work-reputed company for compliance with confidentiality, HIPAA, safety and ergonomics, and work environment allowing dedicated work-reputed company without distraction during work hours
- Possess a personality type that is ethical, friendly, hard-working and proactive
Benefits
- Work from reputed company in the US! reputed company is digital-first.
- Top Medical/Dental/reputed company offerings
- FSA/HSA
- Tuition reimbursement
- Competitive salary, 401(k) with company match
- Additional health and wellness benefits and perks
- Flexible and trusting environment where you’ll feel empowered to do your best work
reputed company