Medical Claims AR Specialist – Payments & Denials

Ortholonestar; Houston (TX); Híbrido; USD 38.000 - 54.000; Jornada completa

Descripción de la vacante

ORTHOLONESTAR is seeking a claims reviewer to review and submit insurance claims on a daily basis in a climate-controlled office. You will prepare and submit clean claims to various insurance companies electronically or on paper and contact carriers for claim status.

The role requires a High School Diploma or GED and at least one year of medical billing/collections experience, with strong attention to detail, numerical ability, and familiarity with HIPAA requirements.

Formación

• High School Diploma or GED, and minimum one year experience in a medical billing/collections field.
• Ability to write and read.
• Math ability: add, subtract, multiply and divide with accuracy.
• Reasoning ability to interpret explanations of benefits to identify denial reasons.
• Basic proficiency in Microsoft Outlook/Office; ability to learn new software.

Responsabilidades

• Prepares and submit clean claims to various insurance companies electronically or on paper.
• Contact carriers by phone or website for claim status on outstanding balances.
• Process and work all insurance correspondence.
• Perform collection actions including contacting patients by phone and resubmitting claims.
• Obtain documentation required to submit to insurance to expedite payments.
• Answer questions from patients, clerical staff and insurance companies.
• Identify and resolve patient billing complaints.
• Prepare appeal letters for denied claims and document collection activities.
• Identify underpayments by checking payments against contracted fee schedule.
• Work and process all insurance refund requests.
• Report payer issues or delays to supervisor.

Conocimientos

Typing 45 WPM

Microsoft Office proficiency

HIPAA awareness

Educación

High School Diploma or GED

Descripción del empleo

ORTHOLONESTAR is seeking a claims reviewer to review and submit insurance claims on a daily basis in a climate-controlled office. You will prepare and submit clean claims to various insurance companies electronically or on paper and contact carriers for claim status.

The role requires a High School Diploma or GED and at least one year of medical billing/collections experience, with strong attention to detail, numerical ability, and familiarity with HIPAA requirements.