Job description
Nine provider OB-GYN office located in West Omaha has a full-time opening for a Medical Claims Follow-up Specialist. We offer a competitive salary and an excellent benefits package including medical, vision, dental, life and long-term disability insurance, paid time off and 401(k) Profit Sharing Plan. We close at 1:00 pm on Fridays.
Qualifications:
- Minimum of one year billing and claims experience, OB-GYN experience preferred.
- Experience with CPT and ICD-10 coding.
- Knowledge of Medicare, Medicaid and Third Party Insurance billing protocols and guidelines.
- Thorough understanding of EOBs and Remittance Advices.
- Effective communication skills for interacting with patients, co-workers, providers and insurance companies.
- Excellent attention to detail with strong organizational skills.
- Independent problem-solving skills.
- Ability to manage time and meet deadlines.
- Experience with electronic medical records is required.
Responsibilities:
- Analyze denied claims to determine if procedures codes and diagnosis codes are mapped correctly for office and hospital charges.
- Ensure compliance with CPT, ICD-10 and HCPCS coding standards.
- Applies a thorough understanding and able to interpret explanation of benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment was received.
- Ability to interpret CMS 1500 claim data to be able to troubleshoot claim edits and resolve payer billing requirements both timely and accurately.
- Ability to follow-up with 3rd party payers for claims and appeals submitted to ensure timely and accurate processing.
- Review insurance remittance advices, researching denial reasons and resolving issues with well-written appeals.
- Resubmits claims with necessary information when requested through paper or electronic methods.
- Miscellaneous other tasks and responsibilities may be assigned at any given time.
Requirements:
- Professional demeanor.
- Self-motivated.
- Strong verbal and written communication skills.
- Dependable.
- Team-oriented.
- Handle multiple tasks at one time.
- Efficient with computers.
- Sedentary position - ability to sit for long periods of time.
- A commitment to maintaining confidentiality and compliance with HIPAA regulations.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Experience:
- billing and claims: 1 year (Required)
Ability to Commute:
- Omaha, NE 68118 (Required)
Ability to Relocate:
- Omaha, NE 68118: Relocate before starting work (Required)
Work Location: In person
