Claims Processor II – Denials & Payer Follow-Up

Medical University of South Carolina; Orangeburg (SC); On-site; USD 28,000 - 39,000; Full time

Job summary

The Medical University of South Carolina (MUSC) Community Physicians is seeking a detail-oriented claims processor to manage insurance claim processing and denial follow-up. The role involves updating registrations, resolving authorization issues, and correcting claims in an electronic billing system in accordance with payer rules.

Candidates should have an Associate's Degree with 2 years of billing and insurance follow up, or 4 years in a hospital or physician office setting, and knowledge of

Qualifications

• Associates Degree preferred with 2 years billing and insurance follow up or 4 years of billing and insurance follow up in a hospital or physician office setting required.
• Knowledge of CPT coding and billing rules; thorough understanding of insurance terminology.
• Epic experience preferred.

Responsibilities

• Account maintenance: updating registration, authorization issues, charge corrections, processing adjustments and denial follow up per payer rules.
• Follow up on outstanding denied claims and no-response claims using electronic billing system; corrects claims as needed.
• Contact third party payers or use payer websites to gather information and resolve denied/no response claims.
• Escalate slow-pay issues when necessary and keep management informed of trends and payer rule changes.
• Maintain 95% quality on accounts and productivity; serve as preceptor and cross-cover as needed.

Skills

Attention to detail

Prioritization

Independent judgement

Effective communication

Education

Associate's Degree

Tools

Epic

Job description

The Medical University of South Carolina (MUSC) Community Physicians is seeking a detail-oriented claims processor to manage insurance claim processing and denial follow-up. The role involves updating registrations, resolving authorization issues, and correcting claims in an electronic billing system in accordance with payer rules.

Candidates should have an Associate's Degree with 2 years of billing and insurance follow up, or 4 years in a hospital or physician office setting, and knowledge of