Claims Processing Assistant- Pediatrics

Henry Ford Health System; Detroit (MI); Remote; USD 35,000 - 55,000; Full time

Job summary

A leading healthcare organization is looking for a Pediatric Billing Specialist to manage insurance claims and improve billing accuracy within their Pediatric department. This full-time position involves preparing claims, resolving billing issues, and working collaboratively in a dynamic environment. Candidates should have a high school diploma or equivalent and preferably have billing experience, especially in pediatric care.

Qualifications

• High School diploma equivalency OR 1 year of applicable job-specific experience required.
• Two years billing experience preferred.
• Pediatric billing experience preferred.

Responsibilities

• Prepares insurance claims for submission to third parties.
• Reviews claims for accuracy including diagnosis codes.
• Resolves billing issues through communication with payers.

Skills

Attention to Detail

Communication

Problem Solving

Education

High School diploma equivalency

2 years billing experience

Pediatric billing experience

Job description

GENERAL SUMMARY

• Department: Pediatric Billing
• Schedule: Full-time Days: Monday - Friday
• Location: Remote after training in Detroit, MI

Prepares and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.

Responsibilities:

· Prepares insurance claims for submission to third party payers and/or responsible parties.

· Reviews claims for accuracy, including proper diagnosis and procedure codes.

· Reviews claim rejections and communicates with payers to resolve billing issues.

· Prepares and reviews routine billing reports. Recommends process improvements based on findings.

· Responds to complex telephone and written inquiries from patients and/or third party payers and physician practices.

EDUCATION/EXPERIENCE REQUIRED

• High School diploma equivalency OR 1 year of applicable cumulative job specific experience required
• Two years billing experience preferred
• Pediatric billing preferred

Additional Information

• Organization: Henry Ford Ascension Medical Group MI
• Department: Pediatrics Prof
• Shift: Day Job
• Union Code: Not Applicable