This client is looking for someone that has the experience in working Blue Cross and Medicare denials. This involves understaning the reason for the denail and how to go about getting the denial paid. You will need to understand the various denial codes on the Medicare remit in order to work the denial if necesssary.

You should be able to maneuver through the various prompts when calling the insurance companies and give the policy number, the date of service, and the NPI number for the physician or practice and then follow whatever protocol is necessary to get the insurance company to pay the claim. This may involve sending documentation, dictations, claims or invoices necessary.

You will need to be able to generate Medicare redetermination letters that are denied in error by Pinnacle Medicare Services.

Candidate MUST be strong in MS Word 2007, Excel 2007, PowerPoint, and some QuickBooks is a plus. Some Typing and Data Entry will be required. .

Must show at least 2 year Medical Claims experience on resume.
Testing on the above skills will be required before being placed in this position.

Candidate must have excellent written and verbal communication skills.  Attention to detail and accuracy are paramount.  Must be very computer savvy and be proficient in all Microsoft 2007.