GROWING HEALTHCARE BILLING COMPANY IS HIRING!

CLAIMS SPECIALIST - FIRST PARTY DEPARTMENT:  Full-time position.  In this role, you’ll investigate and coordinate no-fault benefits for accident claims from auto, home or other liability insurance policies.  Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement.  Review and research accident claims to investigate possible leads.  Coordinate insurance benefits for patients. Contact patients, insurance representatives, and attorneys to verify relevant details and obtain maximum payments.  Bill primary insurance when appropriate.  Request documentation from insurance representatives when no no-fault insurance exists.  Close and return claims to client upon resolution.  Maintain proper account documentation in claims database.  REQUIREMENTS:  The ideal candidate will have at least one year of experience in a professional office environment; experience in health and/or auto insurance preferred.  Experience with Coordination of Benefits and Subrogation is a plus.  High school diploma or equivalent required, along with able to communicate effectively verbally and in writing and be comfortable speaking with patients, attorneys and adjusters on a one-on-one basis.  The successful candidate will also have the proven ability to be assertive in order to proactively analyze and resolve issues.

CLAIMS SPECIALIST - HEALTH DEPARTMENT:  Full-time position.  In this role, you will investigate health insurance claims and bills to ensure claims resolution. Follow-up on unresolved claims and facilitate payment of claims for commercial health, Medicare, and Medicaid. Research and resolve claims for commercial health, Medicare, and Medicaid. File correct UB04’s and 1500 HCFA’s with subrogation information to payers for payment. Prepare documentation to notify clients of action required to bill health insurance, Medicare or Medicaid. Close and return claims to client upon resolution using correct text and procedures in regards to denial process. Conduct timely follow-up activities to determine claim status and collect and/or provide information to resolve the claim. Assist with new employee training. Provide initial one-on-one training in position basics and best practices, and serve as a resource for new employees. Complete special reports as required, such as aged reports, checklist audits, denial reports, etc.  REQUIREMENTS:  High school diploma or equivalent required, along with able to communicate effectively verbally and in writing and be comfortable speaking with patients, attorneys and adjusters on a one-on-one basis.  Experience with Health insurance billing, Coordination of Benefits and Subrogation is a preferred.

CLAIMS SPECIALIST - HIGH DOLLAR DEPARTMENT:  Full-time position.  In this role, you will handle all cases for accounts that exceed $10,000 through the entire process of investigation, verification, billing, and follow up.  Research and resolve claims for auto, premise, commercial health, Medicare/Medicaid, and TPL insurance.  File correct UB04’s and 1500 HCFA’s with subrogation information to payers for payment.  Make written and/or verbal appeals to payers on denied claims.   Close and return claims to client upon resolution using correct text and procedures in regards to denial process.   Review and investigate ICR and client services inquiries regarding client questions, issues and updates.  Work with ICR and client services to resolve issues with client accounts.  REQUIREMENTS:  The ideal candidate will have the ability to communicate effectively verbally and in writing and a detailed understanding of other MRA departments in relation to own department.  The successful candidate will have the demonstrated ability to work independently and follow-through on assignments with minimal direction, and have the proven ability to be assertive in order to proactively analyze and resolve problems.  HS Diploma or equivalent required.  Experience in health and/or auto insurance and experience with Coordination of Benefits and Subrogation requirements preferred.  
 

CLAIMS SPECIALIST -  INFORMATIONAL CLAIMS UNIT:   Full-time position.  In this role, you will verify a patient’s insurance coverage was valid at the time of their hospital visit.  Ensure filing of informational claim prior to health insurance claim deadline.  Review and research cases to determine status of health coverage.  Determine effective date of policy, filing deadline, and claims mailing address.  Investigate and solve potential problems with accounts.   Send informational claims to health carriers and follow through on claim status.   REQUIREMENTS:  The successful candidate will have the ability to communicate effectively, both verbally and in writing and have a high attention to detail in order to produce accurate work, often under minimal supervision.  HS Diploma or equivalent required.  One year of experience in a professional office environment; health insurance or billing experience preferred.

FINANCIAL ANALYST:  Full time position at our headquarters, reporting to the CFO. Provides financial analysis of client and operational data through forecasting, modeling, and reporting in addition to cost impact, profitability and quality analysis. Interprets financial operating statistics, conducts research and makes recommendations to management. Manages internal audits. Develops reports using SQL and Visual Studio. The ideal candidate will have proven ability to effectively communicate with all levels of the organization, both verbally and in writing. The successful candidate will have demonstrated exceptional analysis, problem solving and reporting skills, possess strong multi-tasking and organizational skills, and be able to work independently with minimal direction. REQUIREMENTS: Bachelor’s degree in Finance, Accounting or other analytically focused business degree, along with a minimum of 4 years experience is strongly preferred. Advanced MS Excel and SQL skills with experience writing queries required. Aqua Data, Visio and Visual Studio experience is also required.

TRAINING AND QUALITY MANAGER:  Full-time opportunity in our corporate office in Franklin, TN. Oversees the activities of Training and Quality Improvement (TQI) department. Focuses on identifying training needs for the First Party, Med-pay Scrub, Health, High Dollar, ICU, WC, and TPL departments with the overall goal to improve work quality. Manages the Training and Quality team and performs all supervisory responsibilities. Serves as a resource and trainer for TQI staff in how to deliver and facilitate effective and efficient training and development activities. Plans and develops training programs, using knowledge of the effectiveness of methods and forums such as classroom training, demonstrations, on-the-job training, meetings, conferences, and workshops. Analyzes training needs to develop new training programs or modify and improve existing programs. Develops and organizes manuals, multimedia visual aids and other department educational materials for training and reference. Responsible for meeting and maintaining department benchmarks and goals. Devises and implements team projects and incentives to increase effectiveness. Compiles and reviews various productivity reports and audits such as work-review and client reports in order to identify trends; develops specific training and/or makes protocol changes to address trends. Coordinates the development and publication of policy changes within MRA in conjunction with other departments to facilitate best practices for overall effectiveness. Obtains feedback and provides relevant information to management through training and work review. The ideal candidate will have the ability to communicate effectively verbally and in writing, along with the demonstrated ability to effectively analyze and resolve problems and be assertive in presenting solutions. The successful candidate will have a detailed understanding of or the ability to learn the functions of other MRA departments in relation to the TQI department. REQUIREMENTS: High school diploma or equivalent required, BA/BS preferred. One to three years management experience and at least one year related experience in creating and facilitating activities to develop and educate employees is required. Familiarity with Lean Six Sigma processes and experience with Coordination of Benefits, Subrogation and/or health insurance is a plus.