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Our client is seeking a medical admin for their headquarters in Coral Springs. This candidate must have at least 2-3 years experience within the legal field or dealing with medicare documents.
*Review progress notes to find substantiation for medical necessity for claims submitted.
*Appeal denials with the appropriate documentation per payer requirement and write appeal letters as necessary.
*Cases are reviewed, tracked, and where necessary, researched to ensure timely receipt of appeal or documentation request in order to increase revenue and account receivable.
*Has the ability to read and interpret an Explanation of Benefits (EOB)
*Identify denial trends and makes recommendations for resolutions.
*Works as a part of the company team by communication effectively with all departments.
*Be able to navigate between different computer systems.
*Observes legal and ethical guidelines for Ssafeguardingd prospect and customer Personal Health Information (PHI) as dictated by the Health Insurance Portability and Accountability Act (HIPAA).
*Verifies that appeal case does not contain any omissions or deficit information.
*Adhere to Company Policies and Procedures with an emphasis on professional behavior.
*Plan and organize daily work schedule to meet daily goal efficiently and within deadline.
*Be able to navigate between different computer systems in order to accurately obtain necessary documentation for review or appeal.
*Promotes companies culture by adhering to policy, procedure, mission statement, and Medicare compliance.
*Meets individual, department, and company goals.
*Keep manager/supervisor informed of deficient appeal cases.
*Maintain professional and technical knowledge by attending educational workshops and reviewing professional publications.
*Additional duties as directed by the Department's senior management.
*Maintain an excellent attendance record, including punctuality.
Aerotek, headquartered in Hanover, Md., is a leading provider of technical, professional and industrial staffing services. Established in 1983, Aerotek is an operating company of Allegis Group, the largest provider of staffing services in the U.S. Aerotek operates a network of more than 200 non-franchised offices throughout the U.S., Canada and Europe. For more information, visit Aerotek.com.
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