Reimbursement Representative at Kelly in Monroeville, PA

Company Description

Kelly Services is looking to hire several Site Logistics Operators/Material Handlers in Knoxville, TN for an industry leading chemical company. For this opportunity, you could be placed as a Chemical Finished Product Operator or a Polymers Packaging/Warehousing/Shipping Operator on a long-term, indefinite assignment. You will be working with chemicals and should be comfortable doing such - either with previous experience or the willingness to learn.

Job Description

Job Description:

Title: Reimbursement Representative, Monroeville, PA

Hours: 8:30 - 5:00 p.m.Training Hours: 8:30 - 5:00 p.m.temporary 90 days; possible extension

Pay Rate: $16.29/hr.

Top Must-Haves on Resume:

1.     Minimum 1 year recent healthcare reimbursement
   

2.     Someone who has worked within a call center environment 
   

3.     Great customer service experience
   

4.     Excellent use of MS Office Word/Excel
   

5.     Good mathematical skills
   

Must have recently Health Insurance background Must be proficient in Word and ExcelWill be contacting insurance plans to verify patient coverage and benefits Must have strong organization skillMust be detailed.Excellent Communication Skills Heavy Phones and interactionExcellent Customer Service SkillsIdeal candidate would be someone that has recent experience working in a Doctors office working with Health Insurance companies The below is only a template, please do not use Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.

Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program. Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications. Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors. Researches and resolves any electronic claim denials. Researches and resolves any claim denials or underpayment of claims.

Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. Reports any reimbursement trends/delays to supervisor e.g. billing denials, claim denials, pricing errors, payments, etc. .

Processes any necessary insurance/patient correspondence. Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification NPI number, and referring physicians. Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process. Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims. Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action. Typically receives little instruction on day-to-day work, general instructions on new assignments.

Performs related duties as assigned. Ability to communicate effectively both orally and in writing. Ability to build productive internal/external working relationships. Strong interpersonal skills. Strong negotiating skills. Strong mathematical skills. Strong organizational skills; attention to detail. General knowledge of accounting principles, pharmacy operations, and medical claims. General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred. Global understanding of commercial and government payers preferred. Ability to proficiently use Microsoft Excel, Outlook and Word. Is developing professional expertise; applies company policies and procedures to resolve a variety of issues.

Additional Information

$16.29 per Hour