Collections Claims Clerk

Globalchannelmanagement; Mason (OH); On-site; USD 35,000 - 55,000; Full time

Job summary

Globalchannelmanagement in Ohio is looking for a Collections Claims Clerk to manage claims and collections. You will be responsible for analyzing payment issues, processing refunds, and preparing write offs for approval.

The ideal candidate will have strong research and analytical skills as well as experience in claims management. This position requires proficiency in spreadsheet tools for data handling and communication with payers to resolve outstanding issues.

Qualifications

• Experience in handling claims and collections effectively.
• Strong ability to research and analyze payment trends.
• Proficient in using spreadsheets and queries to manage data.

Responsibilities

• Handle claims and collections effectively.
• Research payment issues and apply for refunds as necessary.
• Prepare write offs for supervisor approval.

Skills

Claims

Collections

V-lookup

Research skills

Job description

Collections Claims Clerk requires:

• Claims
• Collections
• V-lookup denials and action codes from denial log spreadsheet.
• Run query to pull in batch and check numbers associated with claims.
• Research credits to determine whether there are two payments applied to the claim or if there is an overpayment.
• Determine whether a refund is due to insurance or member.
• If there is a refund due, complete refund request. If there are two payments applied and one belongs to a different invoice, complete redirect.
• Open claims with no payment, nor denial, see resubmit instructions.
• If a claim has already been resubmitted and still neither payment, nor denial has been received, contact payer to check status of the claim and work towards a resolution.
• Once all actions have been determined, send write offs for approval to supervisor. For all write offs over $1000, they must be approved by finance manager.
• Identify trends within payers to find issues. If there is an issue within plan set up, forward it to be corrected. Work with payer relations and/or payer directly to resolve outstanding issues affecting payment.