- Follow up on Commercial, Medicaid and Government behavioral health claims by phone calls to the insurance companies, websites, if available, or any other resources.
- Verifies the status of claims that have been billed to insurance companies on a timely basis according to the productivity guidelines for the Claim Status goals.
- Update claim statuses and keep detailed notes explaining changes or issues with claims.
- Identifies, documents, and communicates trends in recurring rejections and denials to Supervisor. Recommends process improvements or system edits to eliminate future denials.
- Compile and submit medical records to insurance companies when required.
- Verifying the coverage and eligibility of new patients.
- Follow-up with facilities, insurance companies, and credentialing departments in regards to claims or billing inquiries.
- Maintains strict confidentiality and abides by all HIPPA rules and regulations.
- Understanding of medical terminology, diagnosis codes, denial codes, ICD 9-10 Codes, and calculating fee schedules.
- Strong understanding of UB's, 1500's and Remittance Advice (RA's).
- Has the experience to know the appropriate questions to ask when calling Insurance companies, to get the necessary information to move forward in resolving the claim.
- Develops a solid understanding of assigned client processes in order to review and analyze claims and account receivable functions.
- Identifies client issues consistently and communicates this to their Manager in a timely manner for quick resolution.
- Adhere to all company policies, procedures and guidelines in addition to insurance regulations at the federal and state level.
-
Claims Specialist
1 week ago
LHH Roanoke, United StatesLHH Recruitment Solutions is assisting our client in their search for a Claims Specialist to join their office in Roanoke, VA. This position will sit onsite and assist with incoming claims related to either personal injury or property damage. This position will be reviewing and i ...
-
REVENUE CYCLE BILLING SPECIALIST
2 weeks ago
New River Valley Community Services Blacksburg, United StatesOur team is growing and searching for our next Revenue Cycle Billing Specialist We are searching for driven individuals who are eager to play an important role in serving the New River Valley. While working with NRVCS, you are subject to our competitive benefits package, a VRS ac ...
-
Threshold Billing Solutions Draper, United StatesJob Description · Job DescriptionUtilization Review (UR) SpecialistPosition Summary: Threshold Billing Solutions provides claims processing and utilization management services for behavioral treatment facilities. The UR Specialist is responsible for collecting clinical informatio ...
-
REVENUE CYCLE BILLING SPECIALIST
4 weeks ago
New River Valley Community Services Blacksburg, United StatesJob Description · Our team is growing and searching for our next Revenue Cycle Billing Specialist We are searching for driven individuals who are eager to play an important role in serving the New River Valley. While working with NRVCS, you are subject to our competitive benefit ...
-
Insurance Coordinator
3 weeks ago
Real Life Dental Blacksburg, United StatesAbout the Practice · At Real Life Dental- Blacksburg, our patients are our highest priority. Our dentists and team give our patients full attention, offering a full range of services. We provide quality care in a warm, relaxing environment and use the latest technologies to ensu ...
-
BlueNova Industries Blacksburg, United StatesJoin us in Blacksburg and take your career to the next level:With our amazing team and constantly evolving projects, your 2.5-year apprenticeship will never be boring – we promise · You will learn the ins and outs of being an insurance specialist, including all relevant processes ...
-
Rev Cycle Specialist- Customer Service
2 weeks ago
Carilion Clinic Roanoke, United States Full timeRev Cycle Specialist- Customer Service · Roanoke, VA, US, 24012 · Employment Status Full time Shift Day Facility RCM Payment Services Requisition Number How You'll Help Transform Healthcare · Do you like to help others? Can you be the smiling, reassuring voice on the othe ...
-
Benefit Programs Specialist I
4 days ago
Commonwealth of Virginia Roanoke, United StatesHiring Range: $39,932 to Commensurate with experience · Full Time or Part Time: Full Time · Do you enjoy helping people? The City of Roanoke is seeking service-focused individuals that are self-starters and able to work independently to assist those residents who receive Medica ...
-
Medical Billlng-Credit Balance
1 day ago
Carilion Clinic Roanoke, United StatesHow You'll Help Transform Healthcare: · This position will serve as a Credit Balance specialist reporting to the manager of the Payment Processing and Credit Balance teams. You may advise candidates that limited remote work, 2 to 3 days per week, is a possibility contingent upon ...
-
QA/Expeditor - Tanglewood-Chili's
4 weeks ago
Chili's Grill & Bar Roanoke, United StatesQA/Expeditor - Tanglewood-Chili's · 4212 Electric Rd · Roanoke, VA 24018 · Role Overview · Our Quality Assurance Specialists ensure each Guest receives perfectly prepared, high-quality food. They provide dependable, fast service that is absolutely Chili's If you take pride in ...
-
Customer Service Specialist
4 days ago
Intact Insurance Salem, United StatesJob Description · We currently have an opportunity for a Customer Service Specialist to join our Operations team in our Salem, VA office. This position is responsible for fielding a of broad scope customer service requests/inquiries from agents, insureds and field staff. Respons ...
-
Safety, Environmental and Security Manager
3 weeks ago
Pyrotechnique by Grucci, Inc. Radford, United StatesGENERAL REQUIREMENTS: · Bachelor's degree in safety or related field with five (5) years of experience in safety. Minimum of three (3) years supervisory experience preferred. · Associate's degree in safety or related field with seven (7) years of experience in safety. Minimum of ...
-
Extension 4-H Specialist, Agriculture
3 weeks ago
Montana State University Radford, United StatesExtension 4-H Specialist, Agriculture & Natural Resources Please see Special Instructions for more details. Please note for this position Five (5) references have been requested.Position InformationAnnouncement NumberAnnouncement Number FAC - VA For questions regarding this posit ...
-
Extension 4-H Specialist, Agriculture
2 weeks ago
Montana State University Radford, United StatesExtension 4-H Specialist, Agriculture & Natural Resources · Please see Special Instructions for more details. · Please note for this position Five (5) references have been requested. · Position Information · Announcement Number · Announcement Number · FAC - VA · For questi ...
-
Extension 4-H Specialist, Agriculture
2 weeks ago
Montana State University Radford, United StatesExtension 4-H Specialist, Agriculture & Natural Resources · Please see Special Instructions for more details. · Please note for this position Five (5) references have been requested. · Position Information · Announcement Number · Announcement Number · FAC - VA · For questions ...
-
Rev Cycle Specialist- Customer Service
2 weeks ago
Carilion Clinic Roanoke, United StatesHow You'll Help Transform Healthcare: · Do you like to help others? Can you be the smiling, reassuring voice on the other end of the phone? Do you mind talking on the phone? Are you looking for a rewarding position that offers room to grow? If yes, we'd love to hear from you App ...
-
Medical Billing Specialist
2 weeks ago
FYZICAL Therapy and Balance Centers Roanoke, United StatesJob Description · Job DescriptionThis is an exciting time to join the FYZICAL family If you have one year of billing experience and would enjoy being part of a champion team with a forward-thinking company that takes a unique approach to physical therapy, you are a great fit for ...
-
Accounts Receivable Specialist
3 weeks ago
RemX Roanoke, United StatesRemX is seeking an Accounts Receivable Specialist to join the team in Roanoke, VA area · Duties & Responsibilities: · Portfolio management of accounts; collect accounts receivable monies by analyzing open balances and taking appropriate action to contact customers; meet or exc ...
-
Supervisory Patient Representative
1 week ago
VETERANS HEALTH ADMINISTRATION Salem, United StatesSummaryThis position is located at the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Mid Atlantic Health Care Network (VISN 6), VA Medical Center, Salem, Virginia. The incumbent reports to the Chief, Veteran Experience Officer in the Veterans Experien ...
-
Supervisory Patient Representative
1 week ago
VETERANS HEALTH ADMINISTRATION Salem, United StatesSummary · This position is located at the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Mid Atlantic Health Care Network (VISN 6), VA Medical Center, Salem, Virginia. The incumbent reports to the Chief, Veteran Experience Officer in the Veterans Expe ...
Behavioral Health Claims Specialist - Draper, United States - Threshold Billing Solutions
2 weeks ago
Description
Job Description
Job DescriptionThreshold Billing Solutions, is seeking a highly motivated team member to join our claims and verification of benefits team. As a Claim Specialist this position will be instrumental in analyzing and following up on billed behavioral health claims to determine the appropriate course of action to resolve the claims.The Claims Specialist will be advocating on the behalf of behavioral health facilities in an effort to obtain reimbursement for services billed. The Claims Specialists will be responsible for submitting claims through our online clearinghouse, following up on claim submission, researching and resolving denials, submitting medical records to insurance companies and verifying the eligibility of new patients.
Responsibilities:The Claims Specialist has the following responsibilities and duties:
Requirements:The Claims Specialist should have the following skills, and experience: (Preferred Not Required)
E04JI800tn6i405gofy
