Medical Claims Coordinator/Processor

Ava Consulting

Paramus, NJ

JOB DETAILS
LOCATION
Paramus, NJ
POSTED
30+ days ago
GENERAL FUNCTION
  • The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action.

MAJOR DUTIES & RESPONSIBILITIES
  • Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
  • Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
  • Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.
  • Determine if denied claims can be corrected and re-submitted to the carrier.
  • Review aging reports to research open balances and resubmit within insurance carrier filing limits.
  • Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
  • Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
  • Initiate overpayment refunds to patients and repayments to insurance carriers when required.
  • Serve as the point of contact for the practice regarding all vision and medical claims.
  • Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS
  • High school diploma
  • 3+ years of related work experience
  • Experience with medical billing and coding
  • Ability to prioritize handling of issues
  • Organization skills and ability to multitask
  • Effective communication skills (verbal, written, listening, presentation)

PREFERRED QUALIFICATIONS
  • Experience working in multiple doctor practices
  • Experience working with multiple insurance carriers and an understanding of their claim requirements
  • Proven ability to identify issues and solve problems .

About the Company

A

Ava Consulting

AVA Consulting provides the Best Talent to our clients.  Our differentiators include: Strong Management team: helping to improve efficiencies. Deep Expertise: truly professional in their approach/delivery. Proven Track Record: worked with organizations of all sizes. Superior Execution: effective processes and well-trained staff. Long term Fulfilling Partnerships: is what we strive for Programs that fit your needs: with a total flexible approach.

COMPANY SIZE
100 to 499 employees
INDUSTRY
Other/Not Classified
FOUNDED
1998
WEBSITE
http://www.avaconsulting.com