Senior Claims Processor – Denials & Payer Follow-Up

C018 MUSC Community Physicians (MCP); South Carolina; Hybrid; USD 57,859,000 - 66,125,000; Full time

Benefits offered by this job

STAR certification

Job summary

MUSC Community Physicians (MCP) seeks an organized insurance claim processor to ensure accurate and timely submission of claims, resolve edits, and address denied or unpaid claims promptly. The role is hourly, full-time, within MCP - Revenue Cycle, and requires attention to payer rules and departmental policies.

Responsibilities include updating registrations and authorizations, following up on denials via payer websites or calls, correcting claims in the billing system, and maintaining 95%

Qualifications

• Associates Degree preferred with 2 years billing and insurance follow up or 4 years of billing and insurance follow up in a hospital or physician office setting required.
• Thorough working knowledge of insurance terminology, CPT coding and billing rules required.
• Knowledge of Epic preferred.

Responsibilities

• Update registrations, authorization issues, and processing adjustments as needed and denial follow up according to payer rules and departmental policies.
• Use electronic billing system to follow up on outstanding denied claims and all no response claims.
• Follow up on denied or no response claims by calling third party payers or using payer websites.
• Maintain 95% quality standards on account follow and activity.
• Provide payer feedback during team meetings and collaborate with groups.

Skills

Insurance terminology

CPT coding

Billing rules

Epic knowledge

Education

Associates Degree

Tools

Epic

Job description

MUSC Community Physicians (MCP) seeks an organized insurance claim processor to ensure accurate and timely submission of claims, resolve edits, and address denied or unpaid claims promptly. The role is hourly, full-time, within MCP - Revenue Cycle, and requires attention to payer rules and departmental policies.

Responsibilities include updating registrations and authorizations, following up on denials via payer websites or calls, correcting claims in the billing system, and maintaining 95%