Claims Specialist I — Medical Billing & Collections

TriCore, Inc.; Albuquerque, Northern (NM, KY); Hybrid; USD 42,000 - 58,000; Full time

Benefits offered by this job

Health insurance

Dental/Vision/Life insurance

401(k) with employer match

PTO and paid holidays

Job summary

TriCore, Inc. is seeking an Accounts Receivable professional to lead patient account collections and payer follow-up.

This on-site role at Journal Center in Albuquerque focuses on AR work for non-government and contracted insurances, with opportunities to optimize processes using XIFIN and Excel. The position requires a high school diploma and prior billing experience, including apprentice training in TriCore’s Revenue Operations.

Qualifications

• High school diploma or equivalent required.
• Minimum of one year of medical billing or claims processing experience.
• Successful completion of TriCore Revenue Operations Claims Apprentice Training program.

Responsibilities

• Collects outstanding accounts receivable on patient accounts from patients, commercial and government payors.
• Pursues collection activities on assigned accounts through resubmission, appeal or reconsideration.
• Works on aged AR reports (no activity and unresolved accessions).
• Researches adjustments and gathers backup to support adjustments.
• Uses online insurance resources to obtain and maintain current information.
• Maintains professional rapport with internal and external customers, including insurance company representatives.
• Identifies trends in payment/non-payment of claims and reports findings to leadership.

Skills

Excel

Word

Medical terminology

Education

High school diploma or equivalent

Tools

XIFIN

Job description

TriCore, Inc. is seeking an Accounts Receivable professional to lead patient account collections and payer follow-up.

This on-site role at Journal Center in Albuquerque focuses on AR work for non-government and contracted insurances, with opportunities to optimize processes using XIFIN and Excel. The position requires a high school diploma and prior billing experience, including apprentice training in TriCore’s Revenue Operations.