Claims Resolution Specialist – Medical Billing

QualDerm Partners, LLC; United States; Remote; USD 27,000 - 38,000; Full time

Benefits offered by this job

Competitive Pay

Comprehensive Health Coverage

Generous 401(k) Plan

Paid Time Off (PTO) and holidays

Company-Paid Life Insurance

Disability Protection

Wellness Plans

Employee Assistance Program (EAP)

Exclusive Employee Discounts

Referral Bonus Program

Job summary

QualDerm Partners, LLC seeks a Billing/RCM specialist responsible for identifying and resolving third-party payer rejections. You will assist in resolution of edits and errors that may result in nonpayment of charges or prevent charges from being accepted by payers.

Responsibilities include entering charges/bills into EMR with input from the coding team, scrubbing claims, monitoring missing charges, and communicating trends to RCM leadership.

Qualifications

• 1-3 years' experience in a medical/insurance environment for physician practice or billing company
• Revenue cycle experience preferred
• Strict attention to detail
• Ability to meet deadlines in a fast paced, start-up, results-oriented environment, as well as excellent organizational skills
• Excellent verbal and written communication skills
• Proficient Microsoft Office Suite products, specifically Excel and ability to analyze large data sets
• Ability to collaborate and work in a team environment

Responsibilities

• Manage claims returned which have failed scrub rules
• Identify and resolve payer rejections in a timely manner
• Enter charges/bills into EMR in coordination with certified coding team/Coding manager
• Monitor missing charges and communicate with RCM management as needed
• Must have knowledge of claim correction, electronic claim submission
• Ability to contact payers when necessary to resolve any issues
• Report any trends in a timely manner to RCM leadership that prevent successful claim submission
• Ability to effectively communicate with other departments such as Coding, AR/Follow-up, Patient Services and Posting

Job description

QualDerm Partners, LLC seeks a Billing/RCM specialist responsible for identifying and resolving third-party payer rejections. You will assist in resolution of edits and errors that may result in nonpayment of charges or prevent charges from being accepted by payers.

Responsibilities include entering charges/bills into EMR with input from the coding team, scrubbing claims, monitoring missing charges, and communicating trends to RCM leadership.