MVA claims specialist

MVA Claims Specialist (Medical Billing & Collections)

Revcare, Inc. - Fairlawn, OH 44333

RevCare Inc. specializes in delivering market-leading revenue cycle services. We partner with hospitals and health systems, providing a strong revenue cycle amid today's healthcare environment.

RevCare Inc. is committed to creating a results-oriented work environment that is both challenging and rewarding. We are seeking talented individuals proficient in MVA medical claims to join our growing team. We are looking for candidates that seek growth, the opportunity to learn, and the drive to advance in their career within the Revenue Cycle industry. Our dynamic team is motivated and seeking new talent to enhance our foundation of success!

Role and responsibilities:

· Communicate with patients, insurance companies, and other stakeholders regarding claim status and resolution

· Actively follow up and collect on all electronic claims, including resolution of any billing errors assigned following established procedures

· Research, appeal, and resolve unpaid MVA claims

· Verify insurance coverage and eligibility

· Respond to correspondence from insurance carriers

· Initiating collection follow-up on all unpaid or denied claims with appropriate insurance carrier

· Research and review auto claims for accuracy and completeness and investigate leads

· Analyze medical records and documentation to determine claim validity

· Ensure proper coding and billing procedures are followed

· Maintain accurate and organized claim files

· Collaborate with healthcare providers, patients, and attorneys to gather necessary information for claims processing

· Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform follow-up activities in a fast-paced environment

· Handle incoming/outgoing mail, scanning, and indexing documents and handling any other tasks that are assigned

· Work independently or as a member of a team to accomplish goals

· Work assigned claim volume timely and efficiently within corporate timeframes.

· High call Volume in both outbound and inbound calls for claim status

· Follow all processes and procedures as set by the Training Coordinator and/or department leadership

· Understanding and staying informed of the changes with procedures, billing guidelines, and laws for specific insurance carries or payers

· Perform other duties as assigned by department manager

· Service center with moderate noise level due to representatives talking, computers, printers, and floor activity

Qualifications:

· Ability to thrive in a fast-paced environment and handle large call volumes. Perhaps in a call center, customer service, and working under metrics.

· Ability to communicate effectively verbally and in writing. Proven ability to speak on a one-to-one basis with patients, attorneys and adjusters using appropriate vocabulary and grammar to explain what is required and obtain information.

· An excellent attention to detail, organizational skills, and ability to manage multiple tasks simultaneously, often under minimal supervision.

· A problem-solving mindset and ability to navigate complex billing scenarios while adhering to regulatory guidelines.

· Demonstrated ability to organize and set priorities according to situational demands.

· Working knowledge of computer functions including the internet, and computer software such as Microsoft Office suite Strong organizational skills with attention to detail

· Time management and reliable attendance

· Familiarity with medical terminology and documentation

· Proficient in using computer systems and software for claims processing

· Ability to analyze complex medical records and documentation

· Excellent communication skills, both written and verbal

· Experience in insurance verification or claims processing is preferred

· Understanding of Medicare guidelines and regulations is a plus

· Epic experience is a plus

Education and Experience:

· Minimum Education: High School Diploma/G.E.D

· Minimum 3+ Years of experience with insurance follow up and insurance collections

· MVA/Auto Claim experience required

· Knowledge of both In Network and Out of Network Facility and Physician Claims.

· Strong communications skills in both oral and written

· Positive attitude, Team player and ability to work independently

· Experience in reading, analyzing and interpreting EOB's is required

· Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans and WC/third party is required

· Proven experience administering appeals in a high-volume claim's environment.

· Proven experience in a production-based environment with concentration on meeting production standards

· Ability to clearly navigate claim follow-up and appeals with insurance companies and representatives

· Demonstrate excellent problem solving and negotiation skills

· Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer applications

· Type 45-60 WPM.

Schedule:

• 8-hour shift
• Day shift
• Monday to Friday

Work setting: In-person/Remote/Hybrid

Job Type: Full-time

Pay: $15.00 - $21.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• In-person

Ability to Relocate:

• Fairlawn, OH 44333: Relocate before starting work (Required)

Work Location: In person