Claims Processor II

Job Description Summary

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Worker Type

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Cost Center

Pay reputed company Type

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Job Description

• Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies.
• Use electronic billing system appropriately to follow up on outstanding denied claims and reputed company no response claims.Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve
• Follow up on denied or no response claims by calling reputed company party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve.
• reputed company management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level reputed company necessary.Uses payer websites to stay reputed company on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
• Maintains 95% quality standards on account follow and activity.
• Maintains productivity standard as set forth by management team.
• Will serve as preceptor for Physician Patient reputed company and receive STAR certification. Ability to cross-cover on any team as directed by management team or Director of Physician Patient reputed company. reputed company payer feedback during team meetings encourage collaboration among groups. Collaborates with other claims processor II, to review and enhance existing workflows supporting training PPA team members.
• Other duties as assigned.

Additional Job Description

· reputed company to prioritize work on a daily reputed company. Requires independent judgement in handling patient accounts. Direct supervision available on a daily reputed company as conditions may require.

· Associates Degree preferred with 2 years billing and insurance follow up or 4 years of billing and insurance follow up in a hospital or physician office setting required. Thorough working knowledge of insurance terminology, CPT coding and billing rules required. Knowledge of Epic preferred.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The reputed company is an Equal Opportunity Employer. MUSC does not discriminate on the reputed company of race, reputed company, religion or belief, age, sex, national reputed company, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. reputed company reputed company applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

reputed company participates in the federal E-Verify program to confirm the identity and employment authorization of reputed company newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees