Medical Claims Specialist

Job Description

Job Description

Centerprise Inc. is seeking to hire a Medical Claims Specialist to join our team.

JOB SUMMARY:

The Medical Claims Specialist performs a variety of billing and administrative tasks including claim submission, claim correction, insurance follow-up and appeals and insurance verification. They will also assist with all other billing and finance duties as needed.

ABOUT THE COMPANY:

Centerprise is a professional services organization providing consulting and Revenue Cycle Management services to Federally Qualified Health Centers (FQHCs). We are located outside Cincinnati, Ohio, and conduct business nationally.

Centerprise is a company on the rise! We are very excited to say that we currently employ 25 staff members, and we are steadily growing! We take great pride in focusing on employee satisfaction. Happy employees; means happy customers!

At Centerprise we offer our clients a wide variety of services, therefore, we require a large range of skill sets within our company. We would love to hear from dynamic individuals who are seeking an opportunity to grow their skills in an upbeat, fast paced, and team-based environment.

Centerprise has a small company feel, with larger company resources. Please refer to our website for more information,

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Follow-up: Regularly monitor patient account insurance balances to ensure timely payment and resolve any outstanding issues.
• Payer Communication: Contact payers regarding payment status, resolve incorrect payment issues, and ensure proper reimbursement.
• Denial Management: Work closely with leadership to address and resolve any denied claims promptly.
• Understanding Guidelines: Stay informed about both government and non-government contractual billing and follow-up guidelines, ensuring compliance with individual payer requirements.
• Payment Resolution: Address issues related to lack of payment or improper payment by government, non-government, and self-payers, ensuring that all incorrect payment issues are resolved promptly.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty completely. The requirements listed below are representative of the knowledge skill and/or ability required.

Minimum Qualifications:

• High School Diploma or Equivalent (GED), associate degree preferred.
• Medical billing experience required. FQHC billing experience is a plus.
• Proficiency with Microsoft Office Suite. Must be able to use Excel spreadsheets.
• Knowledge of Medical Terminology, CPT and ICD-10 Coding, Electronic Billing, and HIPPA
• EHR Experience in required. Preferred experience with NextGen or eClinicalWorks
• Excellent written and oral communication skills

Pay: $18-$20/hour based on experience

Benefits:

• Competitive benefits package, including options to enroll in the following programs: Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Flex Savings Accounts
• 401 (k) Program with competitive company match
• Courtesy Plan, full time staff and their immediate family members are eligible for courtesy treatment at any HealthSource of Ohio office up to $500.00 per family
• PTO and Long-Term Sick Bank, full time employees earn up to 25 days per year in first calendar year: 15 days of Paid Time Off (PTO), and 10 days of Long-Term Sick Bank (LTSB)
• Credit Union Privileges, Sharefax Credit Union
• Quarterly Bonus Incentive Program

Schedule:

• Monday to Friday; no evenings, or weekends
• After training may be eligible to work a hybrid-remote schedule which will include 2-3 in office days per week.

Work Location: Loveland, OH 45140. Must be able to commute or planning to relocate before starting work.

Centerprise Inc. is an Equal Opportunity/Affirmative Action Employer:

Minority/Female/Disabled/Veteran