Remote Billing/claims Rep

About the position

The main purpose of a Claims Analyst at TEKsystems is to process pended medical claims by verifying and updating information on submitted claims and reviewing work processes to determine reimbursement eligibility. This role is crucial in ensuring that payments and/or denials are made in accordance with company practices and procedures. The Claims Analyst will be responsible for organizing and working with detailed office or warehouse records, utilizing computer systems to enter, access, search, and retrieve data efficiently. In this position, the Claims Analyst will prepare and review insurance claim forms and related documents for completeness, ensuring that all necessary information is present. Customer service is a key component of this role, as the analyst will provide limited instructions on how to proceed with claims and may refer clients to other facilities or contractors as needed. The analyst will also review claims to determine whether the claimant is covered under a policy, evaluate the extent of a settlement, and review the policy to determine coverage. Additionally, the Claims Analyst will authorize claim payments, set reserves on payments, and ensure the timely disbursement of funds. This role may involve coordinating or conducting investigations on claims, identifying claims with possible recovery from third parties, and consulting with attorneys, doctors, and agents regarding the disposition of complex claims. This position is designed for individuals who are detail-oriented and capable of managing multiple tasks effectively in a fast-paced environment.

Responsibilities
? Organize and work with detailed office or warehouse records using computer systems to enter, access, search, and retrieve data.
,
? Prepare and review insurance claim forms and related documents for completeness.
,
? Provide customer service by giving limited instructions on how to proceed with claims or providing referrals to other facilities or contractors.
,
? Review claims to determine whether the claimant is covered under a policy and evaluate the extent of a settlement.
,
? Authorize claim payments and set reserves on payments to ensure timely disbursement of funds.
,
? Coordinate or conduct investigations on claims and identify claims with possible recovery from third parties.
,
? Consult with attorneys, doctors, and agents regarding the disposition of complex claims.

Requirements
? High school diploma or GED required.
,
? Bachelor's degree in Business or related field preferred.
,
? 0-2 years of experience required.
,
? 1 year of experience in medical claims processing.
,
? Knowledge and experience in medical billing and coding.
,
? Must have a high-speed internet connection at home.
,
? Strong research capability.
,
? Self-starter with attention to detail.
,
? Proficient in computer programs like Outlook, Microsoft Word, and Excel.

Nice-to-haves
? Medical office training is a plus.

Benefits
? Medical, dental & vision insurance
,
? Critical Illness, Accident, and Hospital insurance
,
? 401(k) Retirement Plan with pre-tax and Roth post-tax contributions available
,
? Voluntary Life Insurance & AD&D for the employee and dependents
,
? Short and long-term disability insurance
,
? Health Spending Account (HSA)
,
? Transportation benefits
,
? Employee Assistance Program
,
? Paid Time Off (PTO), Vacation or Sick Leave

Apply Job!

For more such jobs please click here!