Description: GENERAL FUNCTIONThe Medical Claims Coordinator is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices. Utilize an EHR system and clearing house to review and submit claims to multiple insurance carriers. Review open/unpaid claim balances and take timely action as required. MAJOR DUTIES & RESPONSIBILITIESReview medical claims and transmit to the insurance carrier using the electronic health records (EHR) system and clearing house.Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.Determine if denied claims can be adjusted and re-submitted to the carrier.Review aging reports to research open balances and resubmit within insurance carrier filing limits.Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.Initiate overpayment refunds to patients and repayments to insurance carriers when required.Write-off open claim balances in the EHR system.Serve as the point of contact for the practice regarding all vision and medical claims.Support the corporate manager in maximizing claim collection rate. BASIC QUALIFICATIONS3+ years of related work experienceExperience with medical vision claims and codingAbility to prioritize handling of issuesOrganizational skills and ability to multitaskEffective communication skills (verbal, written, listening, presentation)Proven ability to identify issues and solve problems PREFERRED QUALIFICATIONSOphthalmology experience working in multiple doctor practicesExperience working with multiple insurance carriers and an understanding of their claim requirements Skills Needed: Top 3-5 mandatory and/or minimum requirements:Experience with medical vision claims coding and billing and cash apply experience Top 3-5 desirable attributes/qualifications:Ophthalmology billing experience Note:Hybrid - 2 days onsite (Tuesday - Thursday on site) in office and 3 days WFHWork Hours: 8-430pm 1/2 hour lunchTemp To HireVIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Description:
GENERAL FUNCTION
MAJOR DUTIES & RESPONSIBILITIES
BASIC QUALIFICATIONS
PREFERRED QUALIFICATIONS
Skills Needed:
Top 3-5 mandatory and/or minimum requirements:
Top 3-5 desirable attributes/qualifications:
Note:
Hybrid - 2 days onsite (Tuesday - Thursday on site) in office and 3 days WFH
Work Hours: 8-430pm 1/2 hour lunch
Temp To Hire
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