Job Summary:

The Billing & Follow-Up Representative reviews, researches, and processes claims in accordance with contracts and policies to determine the extent of liability and entitlement, as well as to adjudicate claims as appropriate.

Job Requirements:

• Data entry skills (~50 words per minute).

• Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required.

• Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-10, CPT, HCPCS), and basic computer skills are highly desirable.

The client has built a call-center environment. They're looking to grow this team, so everyone that gets hired will get the opportunity to grow into a leadership position.

• Responsible for coding and processing claim forms

• Reviewing claims for complete information, correcting and completing forms as needed

• Accessing information and translating data into information acceptable to the claims processing system

• Preparing claims for return to provider/subscriber if additional information in needed.

• Maintaining all appropriate claims files and following up on suspended claims

• Assisting, identifying, researching and resolving coordination of benefits, subrogation, and general inquiry issues, then communicating the results

• Preparing formal history reviews

Job Requirements:

Required skills & experience (the “must haves” to be considered)

• Past work experience of at least one year within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing medical claims processing, financial counseling, financial clearance and/or customer service activities is required.

• Ideally want someone with healthcare billing experience. • Ideally want experience with EPIC, or HealthQuest, Athena, IDX, Meditech, Next Gen, or comparable program

• Must have experience working with UB04 and/or CMS1500 billing. • Must have experience working with EOB's, COB's, ICD-10, CPT Codes.

EDUCATION:

• High school diploma or an equivalent combination of education and experience.

• Associate degree in accounting or business administration high desired. JOB TYPE:

• Full-time SCHEDULE:

• M-F Days, 8-5 LOCATION:

• Kentwood, MI WORK AUTHORIZATION: • United States (Required)