HanfordRecruiter Since 2001
the smart solution for Hanford jobs

Medical Insurance AR Specialist

Company: Lags Spine and Sportcare Medical Centers Inc
Location: Hanford
Posted on: March 22, 2020

Job Description:

Description:
Looking for a well-rounded Medical Insurance Claims AR Specialist. Ideal candidate hasminimum 2 years strong hands on claims review and clean up, as well as application of ICD-10, CPT, andHCPCS coding systems and E&M Auditing and Chart Auditing.Candidate must have the ability to review contracts for correct reimbursement, understand how to analyzeERAs, EOBs and other information to identify underpayments, non-payments and denials and how to workthrough to get claims resubmitted and paid. Candidate must also be able to identify trends that can be workedas a project to help capture revenue that would otherwise be written off or lost due to timely filing delays orpayer incorrect application of contractual agreements or incorrect processing of claims.Lags Medical offers a comprehensive benefit package that includes medical, dental, vision, 401k, 11 paid holidays, PTO plan, career growth and much more. At Lags Medical Centers, we turn great expectations into great accomplishments by having a clear philosophy. Our entire staffacross our vast territorytakes immense pride in honoring the beliefs that position us as a leader in musculoskeletal and pain medicine. Every day, we practice what we preach, bringing us closer to our patients, to our community, and to each other.We also understand that we are only as strong as our individual team members, and are always searching for talented and driven people..

Requirements:
Knowledge, Skills and Abilities:1) Knowledge and strong hands on application of claims review and clean up2) Knowledge and strong hands on application of ICD-10, CPT and HCPCS coding systems3) Knowledge and strong hands on application of chart review and documentation auditing4) Knowledge of health insurance programs, coverage offered and third-party reimbursement mechanisms,including Medicare, Medi-Cal, PPO, HMO, IPA, PMG, Military and Veteran, Workers Compensationand their billing guidelines and processes5) Knowledge of various payer Provider Dispute Resolution, First and Second Level appeal processes6) Knowledge of various payer medical necessity guidelines and/or how to obtain these7) Knowledge in interpretation of Claims Aging and Financial Analysis Reporting8) Knowledge of electronic medical record systems9) Knowledge of manual and electronic billing systems and procedures10) Knowledge of eligibility, benefits and authorizations processes11) Knowledge of general office procedures to create efficient and positive work environment12) Skill in communicating effectively to peers, supervisors and patients and to handle stressful situationsappropriately13) Skill in operating personal computer utilizing word processing, spreadsheets, databases, email and otheroffice equipment14) Audits insurance information for appropriateness in current billing system and is able to quickly identifyunderpayments or other trends that may negatively affect cash flows15) Ability to prioritize work and able to work with little or no supervision16) Ability to communicate both verbally and written effectively and efficiently17) Ability to maintain confidentiality of information, most importantly patient financial and medicalinformation18) Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form19) Follows timely filing guidelines per payer to ensure maximum payment20) Ability to understand and respond appropriately, effectively, sensitively to special population groups asdefined by race, ethnicity, language, age, sex, etc.21) Ability to hear and speak well enough to converse over telephone22) Ability to see well enough to use computer efficiently and read computer reports and correspondence23) Strong Excel, Word and Power Point skills24) Willingness to learn, understand and abide by company policies and proceduresProductivity:1) Ensures billing of services meet standards set by medical corporation, federal and/or state guidelines2) Uses good judgment when auditing, preparing and submitting PDRs and Appeals to other entities forpayment3) Completion of daily, weekly and added special projectsQuality Management:1) Constantly alert for ways to improve customer service, improve patient flow, increase productivity, andimprove utilization of resources communicating ideas to supervisor2) Maintains infrequency of denied appeals in the AR process3) Ensures that electronic and hard copy claims are accurate and completed on time.4) Verifies and ensures competency when utilizing EMR and Billing systems5) Uses mathematical accuracy and attention to detail6) Audits of invalid/rejected edits for accuracy in the electronic claim submission process7) Ensures provider correction requests are responded back to billing timely8) Notifies supervisor of unusual occurrences and adheres to policy regarding incident forms and/or patientcomplaints9) Attends and actively participates in staff meetings as requested10) Attends and actively participates in staff trainings, webinars and seminars as requestedReliability:1) Positively supports requests from administrative office and supervisor in implementing policy and newprograms2) Dependable and punctualCustomer Service:1) Sets the example of exemplary patient and insurance customer service2) Responds to patient or insurance representative calls in a professional manner3) Reviews the terms of service performed, sliding fees, third party payments and payment collection withpatient via telephone4) Ensures cleanliness of work environment during operational hours and is always prepared to providefriendly assistance to patients, insurance and staff members PI119173300

Keywords: Lags Spine and Sportcare Medical Centers Inc, Hanford , Medical Insurance AR Specialist, Healthcare , Hanford, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Registered Nurse (RN) - Corrections
Description: Correctional Medicine opening in Fresno, California. This and other rn jobs brought to you by NursingJobCafe.com Travel Nurses - RN - Immediate and Future 13 Week Travel Contracts. Adventure Awaits Accountable (more...)
Company: Accountable Healthcare Staffing
Location: Fresno
Posted on: 04/3/2020

Stepdown RN
Description: trustaff is currently seeking an experienced Stepdown Registered Nurse for a 13-week travel contract. The Stepdown Registered Nurse is responsible for monitoring patients requiring frequent assessment, (more...)
Company: trustaff
Location: Fresno
Posted on: 04/3/2020

Travel Progressive Care - Step Down RN
Description: NurseStat is looking for a Travel Progressive Care - Step Down RN in Fresno, CA.This is a 13 week assignment scheduled to start on 4/20/2020 and run through 7/19/2020.Shift: Nights. Possible on calls (more...)
Company: AHS NurseStat
Location: Fresno
Posted on: 04/3/2020


Travel RN-CVICU - Fresno, CA
Description: Cardiac Care opening in Fresno, California. This and other rn jobs brought to you by NursingJobCafe.com ul li RNnetwork is working with healthcare facilities around the country to help meet the needs (more...)
Company: RNnetwork
Location: Fresno
Posted on: 04/3/2020

Family Nurse Practitioner needed in California, Outside of Fresno
Description: Family Practice/Primary Care opening in Fresno, California. This and other nurse practitioner jobs brought to you by NursingJobCafe.com A busy,
Company: Integrity Healthcare
Location: Fresno
Posted on: 04/3/2020

Travel - RN/RN-Step-Down
Description: Come work at LRS Healthcare, the leading company in our industry. We re proud of our 4.7 rating on Glassdoor and 4.6 rating on Indeed. We are seeking to hire a talented traveling PCU to join our existing (more...)
Company: LRS Healthcare
Location: Fresno
Posted on: 04/3/2020

Sub Acute: Home Health Registered Nurse Job
Description: Great facility in Fresno, CA is in need of a qualified Travel Sub Acute: Home
Company: Advanced Travel Nursing
Location: Fresno
Posted on: 04/3/2020

Cath Lab RN Needed For A 13 Week Contract
Description: Skyline Med Staff is looking for some of the most talented nurses in the industry to fill
Company: Skyline Med Staff
Location: Fresno
Posted on: 04/3/2020

Correctional Medicine Registered Nurse (RN) Supervisor Needed in Fresno, CA
Description: Nurse Manager opening in Fresno, California. This and other nursing administrator jobs brought to you by NursingJobCafe.com Why Wellpath Here at Wellpath, everything that we do is about taking care of (more...)
Company: WellPath
Location: Fresno
Posted on: 04/3/2020

CVICU Travel RN - Job Id: JO02872217
Description: Tailored Healthcare Staffing is seeking
Company: Tailored Healthcare Staffing
Location: Fresno
Posted on: 04/3/2020

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Hanford RSS job feeds