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Claims Specialist - (Albuquerque) in Albuquerque, New Mexico For Sale

Type: Other Jobs, For Sale - Private.

TriCore Reference Labs is hiring Claims Specialists to be part of our dynamic Business Office team! Responsible for collecting accounts receivables on patient accounts, non-government and contracted insurances government payers and secondary billing. Responsibilities include routine follow-up on accounts, working the Rejection Report for contracted insurances, analyzing aged trial balance report for assigned charge-to’s, working the Antrim, Rhodes reports and miscellaneous accounts receivable reports. ESSENTIAL FUNCTIONS: 1. Collect s outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration. 2. Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration. 3. Works account receivables reports (ie aged-trial-balance report), focusing attention on accounts over 60 days. 4. Researches adjustments and pull all necessary backup to support adjustments. 5. Utilizes on-line insurance resources to obtain and maintain current information. 6. Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives. 7. Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate. 8. Customizes reports in Antrim and or Excel to prioritize accounts for collecting. MINIMUM EDUCATION: High school diploma or equivalent. MINIMUM EXPERIENCE: Must have one of the following: One (1) to two (2) years experience as Research Specialist in the Business Office at TriCore. Two (2) to three (3) years laboratory or medical billing/collections experience. Three (3) to five (5) years healthcare or claims processing experience. OTHER REQUIREMENTS: Must be able to type 30 words per minute. PREFERENCES: Basic knowledge of Excel and Word. Knowledge of medical terminology.
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State: New Mexico  City: Albuquerque  Category: Other Jobs
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