We are seeking a talented and proficient Medical Claims Specialist/Analyst for our busy GI/Internal Medicine Clinic.

The Accounts Receivable Specialist will be expected to follow up with insurance carriers on denied, unpaid, or unresolved insurance claims. This position requires a comprehensive understanding of the entire revenue cycle and appropriate actions to take to resolve claim issues with payers in a timely manner.

Job Duties included in this position:

• Obtain claim status via the telephone, internet, and/or fax.
• Conduct research and contact patients and insurance carriers as needed
• Uphold confidentiality regarding protected health information and adhere to HIPPA regulation.
• Communicates with departments for charge information, coding updates, and other information for claim appeals
• Reviews unpaid claims and obtain necessary information to resolve reimbursements.
• Reviews unpaid accounts, initiates correct actions to collect the accounts, and follows up on action to assure expected results is achieved.
• Successfully navigate multiple vendors including but not limited to, payer websites and clearinghouse(s)
• Upholds "best practices" in day-to-day processes and workflow standardization to drive maximum efficiencies across the team
• Must maintain professional and consistent communication with the team
• Routinely collaborate with department managers to correct problems and improve services
• Accurately documents collection activity performed
• Informs manager of identified issues or trends
• Provides timely resolution of assigned accounts
• Successfully submits appeals to insurance companies to obtain reimbursement
• Resolves support tickets submitted by the client and assigned to department according to metrics assigned
• Manages time and multi-tasks appropriately to meet expectations of management and peers
• Remote employee is responsible for sufficient internet connectivity and equipment necessary to complete assigned job duties in efficient manner

Minimum Qualifications, Skills and Abilities:

• High School Diploma or equivalency required
• Prior Greenway Intergy experience preferred
• Gastrointestinal experience preferred
• 2+ years’ experience in healthcare (professional) billing, health insurance follow up
• Adhere to all HIPAA guidelines
• Excellent communication skills and problem-solving skills
• Ability to read and understand an EOB
• Ability to manage multiple tasks/projects simultaneously and adapt to frequent priority changes
• Ability to work both collaboratively and independently
• Capacity to identify and implement improvement opportunities where enhanced processes, technology, or efficiencies can be applied
• Proficient technical skills and customer satisfaction skills, including ability to troubleshoot products, use MS Office including Excel applications and webinar software
• Escalate recurring billing issues, and make recommendation on process and system improvement opportunities
• Completes other assignments as requested and assigned
• Ability to navigate occasionally complex workflows
• Strong attention to detail
• Technically savvy with claims billing software and Microsoft Office, with a desire to learn new software as well