Medical Claim Specialist, Cardiology, FT, Days Job Listing at Community Health Systems in Springdale (Bentonville Region), AR

Hospital / Healthcare

Title: Medical Claim Specialist, Cardiology, FT, Days
Location: AR-Springdale (Bentonville Region)
Summary:
Performs follow-up on open insurance items. Monitors and researches claims rejected by the claims clearing-house system to determine the cause of the rejection and if appropriate, re-submit claims for payment.

Essential Duties and Responsibilities: Include the following. Other duties may be assigned.
* Acts as the liaison between the Cardiology Claims team and other internal departments
* Follows up on daily rejections of primary and secondary claims in the electronic claims clearing-house system
* Initiates calls to clinics
* Maintains daily rejections log and safety network report
* Escalates rejections that can not be resolved to Claims Lead
* Reports formatting and other issues to Claims Lead
Education and/or Experience Preferred:
High school diploma or general education degree (GED); 1 year experience with insurance billing, account follow-up procedures and electronic claims processing including experience researching and resolving claims rejected by the claims clearing-house system; or equivalent combination of education and experience.

Language Skills:
Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to physicians, practice managers, clinic staff, and other employees of the organization. Ability to effectively communicate with insurance carrier staff and vendor staff.

Reasoning Ability:
Ability to apply common sense understanding to carry out detailed written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Computer Skills:
To perform this job successfully, an individual must have knowledge of general computer applications and practice management systems.Primary Locaiton: AR-Springdale (Bentonville Region)

Organization: Northwest Health System Springdale