Job Description

Job Description

Job Description

Do you have a strong attention to detail? Have you worked in Medical Billing, specifically in claims, denials, and appeals? Our client, a national medical supply company in Glen Allen, is now hiring Medical Claims Credit Reviewers!

Position: Medical Claims Credit Reviewer

Location: Glen Allen, VA
Compensation: $18-19/HR – Based on experience

Schedule: Monday – Friday, 8:00am – 5:00pm

POSITION SUMMARY:

Ensures that the company properly reimburses the insurance companies for claims identified as overpayments and assists with identifying trends to determine if a valid credit for refund or a fee schedule variance exists. Communicates effectively with key decision makers within the company. Undertakes all work in accordance with law, regulation, payer requirements, and company requirements and policies.

JOB TASKS / FUNCTIONS:

• Research and resolves overpayments with claims, including refunding and communicating with the insurance companies or customers.
• Identifies discrepancies and effectively works toward their resolution or communicates to other personnel for resolution as appropriate.
• Monitors refunds to ensure properly retracted by payers. If not retracted, the associate must investigate with the payer to determine the root cause.
• Effectively communicates with revenue management staff, including potential changes to PayerPro, changes in fee schedule, etc…
• Performs all other duties as assigned, which may vary at any time with or without notice.

MINIMUM QUALIFICATIONS:

• Able to complete tasks in specified time frame
• Demonstrates strong organization skills and proven ability to multi-task and manage time in order to meet frequently changing deadlines in a fast-paced environment
• Demonstrates superior professional ethic and commitment to working appropriately with and managing highly confidential and sensitive information and personal situations with ability to effectively ensure complete security
• Demonstrates excellent interpersonal, oral, and written communication skills
• Demonstrates excellent organizational skills as well as strong attention to detail
• Demonstrates a flexible helpful attitude and willingness to take on additional responsibility during periods of lighter workload

PREFERRED QUALIFICATIONS:

• High School Diploma and/or GED required
• Associate’s degree in general studies, accounting, finance or similar course of study
• Proficiency in Microsoft Office Suite
• Proficiency in Claims Management systems
• Experience with insurance billing and/or collections

PHYSICAL REQUIREMENTS:

• Ability to sit for extended periods, typically 6-8 hours a day, while working at a computer station
• Proficiency in using a keyboard, mouse, and other computer peripherals for data entry and communication purposes
• Ability to view a computer screen for prolonged periods, with good visual acuity to read small print and accurately enter data
• Adequate hearing ability, with or without correction, to understand and respond to customer inquiries via telephone or other audio equipment
• Regular use of the hands, wrists, and fingers to perform repetitive tasks such as typing and using a mouse

WHY WORK FOR QUALIFIED STAFFING?

• We offer a fantastic benefits package to all of our employees. This includes healthcare, vacation/holiday pay and 401K! In fact, these are the same benefits that we offer our corporate employees!
• Applying for one job with Qualified Staffing is like applying for hundreds of jobs all at once!
• We respond to every job applicant within 24-48 hours.

INDRic

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