(Contract) Medical Claims Resolution Specialist

pMDsoft, Inc.; United States; Remote; USD 30,000 - 50,000; Full time

Job summary

Join a dynamic team dedicated to enhancing healthcare by resolving medical claims efficiently. As a Medical Claims Resolution Specialist, you'll play a crucial role in maximizing revenue for physician practices through diligent follow-up on insurance receivables. This contract position offers the flexibility of working as an independent contractor, allowing you to manage your time effectively. If you have a keen eye for detail and a passion for helping healthcare professionals thrive, this opportunity is perfect for you. Embrace the chance to make a significant impact in the healthcare sector while enjoying the autonomy of your role.

Qualifications

• Prior experience in collections or medical billing is essential.
• Must have a basic understanding of medical codes and terminology.

Responsibilities

• Contact insurance carriers to secure payment of claims.
• Conduct research on unpaid or denied claims.
• Document account activity in the software solution.

Skills

Attention to detail

Effective communication

ICD-10 knowledge

HCPCS knowledge

Medical terminology

Tools

Claims management software

Job description

We hold ourselves to exceptionally high standards in order to provide unparalleled service to healthcare professionals, their staff, and patients. We strive to end each workday knowing that we’ve made someone’s life better.

Our team is comprised of courageous and caring healthcare warriors. We’re here to solve the impossible problems, such as reducing medical errors, saving patient lives, and empowering physicians to stay financially independent. We care deeply about making a big impact and we are relentless.

Inspired to grow the company and our careers, we remain committed to daily discipline, self-improvement, and a ceaseless search for solutions.

We equally value our work and our life apart from work. We’re compelled to work with urgency, decisiveness, and efficiency in everything we do. This affords us freedom and time for things that matter most.

Leaders at pMD are developed through our mentorship program. Investing in the success of each individual strengthens our team and builds loyalty. We believe in leading by example. Everything one does ripples outward. Therefore, we need each individual at pMD to embody our leadership principles to thrive as an enduring great company.

(Contract) Medical Claims Resolution Specialist

The (Contract) Medical Claims Resolution Specialist role at pMD helps our physician practices maximize revenue through aggressive follow-up on healthcare insurance receivables. This role will help our team gain valuable information to aid in the resolution of outstanding claims and support prompt payment.

Responsibilities include:

• Contact insurance carriers to inquire about the status of past due accounts to secure payment of claims.
• Conduct research to update the status of unpaid or denied claims.
• Document details of activity on each account in software solution program.
• Demonstrate the highest level of compliance with all laws and regulations, including but not limited to HIPAA.

Requirements include:

• Make phone calls to insurance carriers between the operating hours of 8 am and 6 pm EST.
• Exceptional attention to detail.
• Experience communicating effectively with payers.
• Prior collections or medical billing experience with a basic understanding of ICD-10, HCPCS, and medical terminology.
• W9 required - must currently work as a sole proprietor or have or be willing to register a business per independent contractor guidelines.
• Reside in the U.S.

Rate: $6.00 per claim. This role is paid on a per-verified claim basis.

We are only accepting applications through our online job portal, Lever. We aren't able to consider and respond to other types of applications, including those sent via email to pMD support, at this time. Please direct application status questions to [e-mail].

Candidates must be authorized to work in the U.S. as a precondition of employment.