CLAIM SUBMISSION REPRESENTATIVE Job at Beacon Orthopaedics & Sports Medicine
CLAIM SUBMISSION REPRESENTATIVE
Full-Time Monday-Friday
Hybrid Position with 1-2 Days in Office
Department: Revenue Cycle Management
Location: Summit
Responsible To: RCM Manager
Responsible To: RCM Manager
Position Summary:
Perform electronic claim submission for all payers. Correct first pass claim edit errors from Practice Management System. Correct clearinghouse errors.
Position Responsibilities/Standards:
General
- Attend department, clinic or company meetings as required
- Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
- Consistently work in a positive and cooperative manner with fellow staff members.
- Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
- Attend required annual in-service programs.
- Demonstrate knowledge and understanding of all company policies and procedures. Adheres to established facility safety requirements and procedures to ensure a safe working environment. Identifies potentially unsafe situations and notifies supervisor.
- Adaptability to changing procedures and growing environment.
Specific Duties
- Assure timely and accurate submission of claims to maintain the highest quality of service and timely payment.
- Submits all paper claims and supporting documentation as required by payers.
- Reports any errors trends/delays to supervisor.
- Researches and resolves any electronic claim delays within 24 hours.
- Correction of clearinghouse errors.
- Participates in continuing educational activities relative to assigned duties and responsibilities.
- Perform other duties as assigned by management.
Education/Experience Required:
- High school graduate or equivalent.
- Medical Billing Experience including CPT and ICD10
Experience Preferred:
- Experience with electronic health records/practice management system.
- Understanding of major insurance carriers including, HMOs, PPOs and governmental payers.
- Proficiency in Explanation of Benefits (EOB) methodologies and principles.
- Sound judgment, maturity, and an ability to establish good rapport with patients, public, and staff.
- Ability to calmly handle multiple tasks at once, and deal with patients and staff with tact and diplomacy.
Work Environment/Physical Requirements:
Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and feel objects. Must be able to climb, pull, push and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs.
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