Healthcare CSR - Remote - Up to 35K
Healthcare CSR - Remote - Up to 35K
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1 Vacancy
Job Description
We are looking for CSRs for a client in the Healthcare Industry.
This role is on a REMOTE setup and follows a Night Shift Schedule.
Salary pays up to 35K Package
Minimum requirement of at least 3 years of Healthcare experience in a BPO setup
Essential Duties and Responsibilities:
- Processes opportunities such as verifying benefits requesting authorization & following up on authrequests.
- Completes data fields within the system with insurance information needed for claim submission start & end dates of authorization and others
- Prepares correspondence to insurance companies Health Care Professionals (HCPs) & other affiliates on behalf of patients such as authorization requests appeals & letters of agreement
- Clearly documents all correspondence in the company databases.
- Troubleshoots and seeks solutions to problems related to questions and concerns over authorization and claims.
- When other team members are absent or not available provides backup coverage for their territories/insurance/state.
- Support education of team members on insurance verification authorization and claims
- Analyze and investigate denied claims and find ways/resolution for payment.
- Do outbound calls to different insurance companies to confirm information submit/validate an authorization or claim submission/denials.
- Identify denial patterns and escalate to management as appropriate with sufficient information for additional followup and/or root cause resolution.
- Assumes and performs other duties as assigned.
Required Qualifications:
STRONG US HEALTHCARE COMPREHENSION
- Must understand the intricacies of medical and pharmacy insurance coverage.
- Must know and understand the difference between HMO PPO EPO Indemnity POS Home Plans and Host Plans and be able to clearly communicate that to a patient and or another caregiver or medical professional.
- Must understand different denial reasons and claim status.
- Must understand CPT/HCPC codes ICD 10 claim forms.
- Ability to learn and retain the specific criteria and requirements for different insurance plan
STRONG COMPUTER AND PHONE SKILLS
- Must be able to create Word documents work in Excel use templates use the internet Outlook and work in a company created database
- Must be pleasant and knowledgeable when speaking with insurance company representatives
Preferred Qualifications:
- 3 years of US HEALTHCARE experience Authorization and billing experience or insurance collections preferred.
- Proven knowledge of and experience with ICD9/10 HCPCS and modifier coding.
- Outstanding interpersonal verbal and written communications skills required.
- Must be flexible and able to work in a fastpaced heavy volume work environment.
- Demonstrated computer prioritization and time management skills.
- Experience working at insurance companies/payors or with medical device reimbursement for a startup or new technology company or durable medical equipment setting is high desirable.
Education and Experience Requirements:
- Bachelors degree preferred.
Language Skills:
- Must be able to communicate effectively in English.
- Ability to read and interpret documents such as safety rules operating and maintenance instructions and procedure manuals.
- Ability to write routine reports and correspondence.
- Ability to speak effectively before groups of customers or employees of organization.
Employment Type
Full Time
