Claims & Appeals Specialist
Roth Staffing Companies

Claims & Appeals Specialist

We have partnered with a local Medical Office in Tarpon Springs, who possesses great multi-tasking skills, has high attention to detail, and has effective communication skills.

Responsibilities:

* Following up on claims from billing through final resolution

* Verifying claims status with insurance agencies

* Reviewing and preparing claims for electronic and hard copy billing resubmission

* Denial and Appeal Management on all payers

* Identifying and correcting billing errors and resubmitting claims to insurance carriers

* Providing review and remittance advice for payment errors, denials, and under payments

* Acting cooperatively and courteously with patients, visitors, co-workers, and management

Qualifications:

* We are seeking a candidate with strong organizational and communication skills. The candidate should also be able to effectively prioritize, multitask, and demonstrate an attention to detail. Additionally, they must be able to maintain a professional attitude and confidentiality at all times.

* Minimum 2 years of experience in insurance collections, including submitting and following up on claims from commercial, governmental, or private insurances

* Ability to read and understand EOBs Claim Adjustment Reason Codes

* Ability to identify, track and report payer denial trends to management

* Knowledge of ICD-10 and CPT codes and Payer medical policies

* Experience in Accounts Receivable for commercial, government, and managed care accounts

* Experience in outpatient and/or hospital billing and collections / facility billing

* Proficiency with MS Office with a focus on Excel skills

* Able to work independently or within a team

* Experience with NextGen is preferred but not required

Hours: 8AM - 5PM M-F

Pay: $18-$20/ Hour DOE

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. To the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.