Job Description

TITLE: Claims Review Associate

LOCATION / HOURS: Work from Home / Part-Time (10 hours/week expected)

IMS CORRECTIONAL HEALTHCARE OVERVIEW: IMS Correctional Healthcare, LLC (“IMS”) is a correctional healthcare services company focused on providing medical care services to county and municipal correctional facilities in North Carolina and surrounding states. IMS serves county correctional facilities that typically range from 100 – 1,000 bed capacity and differentiates itself based on its level of customer service, quality care, clinical outcomes and overall operational transparency to the customers it serves.

EXPERIENCE:

• Associates Degree or higher, or equivalent work experience
• 1-3 years of claims review or previous hospital billing experience
• Familiarity with Medicaid fee schedules is preferred

OBJECTIVES AND RESPONSIBILITIES:

Correctional facilities are unique in the Hospital Billing environment in the sense that when an inmate is sent to an emergency room for care, the hospital will bill the County Government directly instead of insurance companies. North Carolina law stipulates the guidelines within which the hospital can seek payment from the County budget, however, mistakes can still be made. Hence IMS is seeking a Claims Review Associate to join its administrative team and assist customers in ensuring the integrity of medical bills that they receive. The Claims Review Associate will be responsible for the following:

• Utilize claims processing experience and knowledge of Medicaid to identify discrepancies in claims received from outside medical facilities
• Work in tandem with County billing and administrative teams to act upon requests in a timely manner
• Effectively communicate findings and act on the customer’s behalf in resolving billing discrepancies with hospitals and other outside medical facilities
• Demonstrate organizational skills, strong attention to detail, and a commitment to customer service
• Follow and uphold all established procedures and protocols as it pertains to the distribution of information, and maintain patient confidentiality as it relates to federal and state health information and privacy laws
• Other responsibilities as recommended by the Sales and Customer Relationship Manager or Company President on a case-by-case basis

It is our hope that this role will serve as the foundation of the IMS Claims Review Department as we look to expand in the state of North Carolina. To the extent that a candidate has a strong business sense and entrepreneurial spirit, the opportunity to lay the groundwork for a business unit exists.

START DATE: Flexible, but prefer to hire as soon as possible

COMPENSATION:

• $15 - $20/hour commensurate with experience
• Annual performance bonus granted at the discretion of ownership based on individual and company performance