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    MedPro Claims Research Specialist lll - Pensacola, United States - West Florida Medical Center Clinic PA

    West Florida Medical Center Clinic PA
    West Florida Medical Center Clinic PA Pensacola, United States

    1 week ago

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    Description
    Job Type

    Full-time

    Description

    JOB SUMMARY

    Under the direction of the MedPro Claims Research Supervisor, the Claims Research Specialist III is responsible for performing the duties related to insurance follow up/collection and maintaining of accounts receivables.

    ESSENTIAL DUTIES AND RESPONSIBILITIES
    • Ability to work all carriers accurately and efficiently including "Special Accounts" (i.e. WC, MVA, etc.)
    • Work weekly worklist:
    1. Carrier specific worklist daily
    2. No activity
    3. Manager Respond (Goal: 48 hours)
    • Ability to effectively and efficiently work client specific claims as outlined in MedPro/client contracts.
    • Work insurance requests.
    • Work correspondence.
    • Work rebilled HCFA claim forms.
    • Respond to questions from MedPro customers and billing staff related to insurance or account A/R activity in a courteous and professional manner.
    • Communicate with Claims Research Supervisor on carrier trends
    • Perform error corrections.
    • Ability to effectively communicate via claim notes per MedPro policy and procedure.
    • Update patient accounts with the correct insurance information.
    • Refile coding denials with appropriate material received from the Consultant Practice Manager (CPM).
    • Complete assigned projects within deadline, as directed by the Claims Research Supervisor.
    • Perform daily functions with minimum guidance from Claims Research Supervisor.
    • Accurately follows written and verbal instructions.
    • Other duties as assigned by management are accepted willingly and completed in a timely manner.
    CORPORATE CULTURE RESPONSIBILITIES
    • Follow established corporate and department-specific policies and procedures.
    • Attend all corporate and department-specific required training.
    • Uphold MCC's Purpose, Values, and Vision.
    • Abide by MCC's Corporate Culture Responsibilities.
    • Perform other duties as may be assigned cheerfully and willingly.
    Requirements

    EDUCATION/EXPERIENCE REQUIREMENTS
    • Minimum education requirement is high school diploma, or equivalent.
    • Minimum 1-year insurance billing experience or equivalent.
    • Minimum 1-year medical billing software or equivalent.
    KNOWLEDGE, SKILLS AND ABILITIES
    • Ability to prioritize and manage multiple tasks.
    • Displays customer services skills, strong interpersonal skills, close attention to detail, excellent verbal and written communication skills, and basic math skills.
    • Be a person of integrity and character, willing to embrace change and make a positive impact in the lives of patients and co-workers.
    • Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
    • Displays computer proficiency (i.e. PC Windows, MS Office) and ability to quickly learn new applications.
    • Acceptable typing speed and accuracy with ten-key by touch skills.
    • Proficient in use of English language both in written and verbal communication.
    • Must be able to communicate with individuals of varying socio-economic backgrounds.
    • Must be committed to the protection of confidential information, records and/or reports.
    • Possess strong critical thinking and analytical skills.
    PHYSICAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS
    • Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
    • Standing/Walking: Occasionally; activity exists up to 1/3 of the time
    • Keyboarding/Dexterity: Frequently; activity exists from &fac34; of the time
    • Ability to look at a computer screen for extended periods.
    • Ability to perform constant repetitive hands and finger motions.
    • Ability to maintain focus while working in close proximity to others.
    • Talking (Must be able to effectively communicate verbally): Yes
    • Seeing: Yes
    • Hearing: Yes
    EMOTIONAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS
    • Must exhibit stable work behaviors daily.
    • Must possess adequate individual coping skills.
    • Ability to remain calm and professional regardless of workload or time constraints.
    • Must be able to work under stress and remain calm and professional.
    WORK ENVIRONMENT
    • Office environment
    • Exposed to frequent and constant interruptions in daily functions/schedule.
    • May be required to work extended hours to meet department needs.