Claims Submission Specialist

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  • 18-00207
  • Full Time/Contract
  • Claims
  • Santa Ana, CA
Job Description
CLIENT COMPANY OVERVIEW
Our client is the largest and fastest growing on-site radiology practice in the U and are an innovative practice focused on transforming how radiologists provide consistently exceptional services to hospitals, imaging centers, referring physicians and patients.

POSITION SUMMARY
Claims Submission Specialist

The Claims Submission Specialist is responsible for monitoring and editing claims data prior to submission. They will monitor edits, exception, and response reports to identify and ensure successful electronic claims submission and make corrections as necessary. Works with management to identify issues and opportunities for improvement in claim submission processes and systems.

POSITION DUTIES AND RESPONSIBILITIES

  • Monitors and corrects daily claims information via tools provided to ensure cleanliness of claims prior to payer submission
  • Responsible for editing and correcting claim exceptions in the practice management system as well as clearinghouses, etc. to ensure timely and correct payment
  • Identify and communicate claim edit requirements; ensure they are set up appropriately in claims edit software
  • Responsible for identifying problematic claim trends and working with the payer representatives, third party clearinghouses or teammates to correct.
  • Monitor and correct claims data inconsistencies
  • Monitor front end payer rejection habits and work to circumvent these issues

DESIRED QUALIFICATIONS / REQUIREMENTS

Education and Experience:

  • High School Diploma or equivalent is required
  • Minimum three years of medical billing experience, some college preferred
  • Demonstrated knowledge of healthcare reimbursement, commercial and government payors, and the electronic submission of claims preferred
  • Ability to maintain/exceed productivity levels; processing 200 claims daily
  • Excellent communication and problem-solving skills
  • Ability to think critically and identify the global impact across the revenue cycle with a solution-oriented approach
  • Knowledge and experience interfacing with revenue cycle clearing-houses
  • Strong interpersonal/communication skills
  • Detailed oriented and demonstrate a high degree of accuracy when performing data entry and claim correction
  • Proficient computer skills; Strong level of organizational skills
  • Self-starter; can initiate and perform tasks without continuous direction

COMPENSATION
$16.00/hr – $18.50/hr

SCHEDULE
Monday – Friday

POSITION CLASSIFICATION
Full Time; Contract/Contract-to-Hire
 


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