Hanger, Inc.

Empowering Human Potential

Priority Claims Specialist III

Claims SpecialistClaims SpecialistFull TimeRemoteTeam 5,001-10,000Since 1861H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

38 days ago

Salary

$20 - $25 / hour

High School5 yrs expEnglish

Job Description

• Ensure payment for services provided is accurate, timely and fully documented. • Provide efficient cash collection through excellent reimbursement practices while ensuring compliance with relevant laws and regulations. • Maintain exceptional support and communication with all partners, internal and external. • Maintain a working knowledge and understanding of DMEOPS CPT and ICD-10 codes. • Utilize the company billing and collections system to identify and resolve any claims that have been unpaid, short paid and/or denied. • Review EOB's and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms. • Follow up with insurance companies by online portal, phone, email and/or fax. • Identify billing errors and submit corrected claims to insurance carriers. • Provide timely and accurate follow up on accounts until they are resolved. • File and follow up on appeals and disputes. • Communicate identified AR issues that may cause payment delays or write offs to management. • Document all findings with clear and concise detail. • Research insurance guidelines and manuals for additional information. • Perform adjustments in the system as needed. • Submit medical records upon request. • Resolve outstanding accounts receivable problems. • Respond to and resolve inquiries from customers or external collection resources.

Job Requirements

  • Minimum High school education or equivalent
  • 5+ years of related experience to include at least one of the following areas: Insurance reimbursement, medical policy, payor appeal requirements or patient collection laws.
  • Experience in a medical office.
  • Preferred Associate’s degree.
  • Experience with NextGen and/or OnBase.
  • Licensed Medicare auditor or Certified Medical Audit Specialist.

Benefits

  • 8 Paid National Holidays & 4 additional Floating Holidays
  • PTO that includes Vacation and Sick time
  • Medical, Dental, and Vision Benefits
  • 401k Savings and Retirement Plan
  • Paid Parental Bonding Leave for New Parents
  • Flexible Work Schedules and Part-time Opportunities
  • Generous Employee Referral Bonus Program
  • Mentorship Programs- Mentor and Mentee
  • Student Loan Repayment Assistance by Location
  • Relocation Assistance
  • Regional & National traveling CPO/CO/CP opportunities
  • Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest

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