Claims Processor

Work at Home
Immediate

Job Description

Grow with a company that is passionate about helping you maximize your full potential. Become a part of transforming customer and client experience through the utilization of our innovative work from home technology. At BroadPath we believe in assuming the highest intention for others, our employees are empowered through their voices which helps us to continue shaping the emerging future, bringing innovation, and flexibility to the Work from Home Industry. Claims processors will be responsible for the accurate and timely entry, review, and resolution of simple to moderate complexity claims in accordance with guidelines, procedures, and policies.

Responsibilities

  • Review of denials and/or incorrect payment for possible appeal. This may include the use of the following guidelines and/or reference tools:  CPT, ICD9, HCPC, medical terminology manuals; Correct Coding Initiative Edits; Medicare Fee Schedule; and modifier rules
  • Work electronic claim edits to ensure accuracy and completeness of all required information being sent to payers
  • Post insurance and patient payments, utilizing correct denial codes for proper account management
  • Communicate with physician offices to obtain additional information required to resolve edits and/or to appeal denied claims
  • Handle and resolve insurance and patient correspondence
  • Work self-pay accounts
  • Retrieve all required information in order to evaluate the validity of refund requests
  • Participate in the mailing of patient statements
  • Monitor IDX billing system setup to ensure compliance with all relevant payer information billing requirements
  • Complete work assignments in an accurate and timely manner
  • Attend department, unit, and other meetings as required

 


Basic Qualifications

  • IDX Experience required
  • ICD 10 Code knowledge is required
  • Excellent technical abilities and knowledge of daily computer handling
  • Previous experience working with health insurance claims on the payer or provider side
  • Knowledge of medical/insurance billing required
  • Excellent communication and customer service skills
  • Ability to determine the reason for unpaid claims or patient accounts and determine the best and most efficient ways and methods to communicate appeal and provide correct documentation to resolve unpaid claims
  • Ability to follow the payer and government rules and regulations in the revenue cycle process
  • Ability to effectively communicate with physicians and practice staff to obtain additional information to resolve edits/unpaid claims
  • Ability to communicate with patients about their account

Preferred Qualifications

  • EPIC Tapestry Claims background highly preferred

Our Claims Processor will receive the following benefits: 
  • Access to BroadPath's Limited Medical Plan starting first of the month after 60 days of employment. After one (1) year of full-time employment, you will receive access to our Major Medical Plan and 401k
  • Bhive kit; includes web camera which allows you to join our Connected Culture!
  • Employee Referral Bonus Program (Uncapped)
  • Weekly Pay