Carolina Health Specialists

Role Description INSURANCE COORDINATOR needed for busy medical practice in Myrtle Beach. Remote position. Must have excellent computer and customer service skills. Hours are MON.-THURS. 7:45AM-5:15PM; FRI. 8:00AM-12:00PM. No nights or weekends! General Summary of Duties: - Responsible for payment of claims using established Central Billing Office policies and procedures. - Work unpaid/denied claims by payers. - Review and work paid claims for reimbursement accuracy. - Interact with office/clinical staff, patients, and healthcare plan representatives regarding these claims. Typical Physical Demands: - Requires sitting for long periods of time and working in an office environment. - Some bending and stretching required. - Working with telephone and computer required. - Manual dexterity required for use of calculator, mouse, and computer keyboard. Typical Working Conditions: - Normal office environment. Examples of Duties: - Researches all outstanding claims through the claims worklist in Athenanet. - Acts as resource to physicians and office staff on insurance payer payment policies and procedures. - Ensures timely response from payers of assigned claims. - Researches correspondence and refund/recoupment requests from insurance carriers in a timely manner and ensures payer contract language is followed by both parties. - Responds to all claim denials for research and appeal according to CBO policies and procedures. - Brings problems to the attention of supervisor. - Assists with answering patient questions regarding their specific insurance plan. - Implements special projects with payer representatives as needed for proper processing of claims. - Participates in educational activities. - Maintains strictest confidentiality abiding by HIPAA regulations. - Performs related work as required. Qualifications - Knowledge of billing procedures, insurance policy and procedures, and outpatient office/clinical operating policies and procedures. - Skill in using computer and calculator. - Ability to examine documents for accuracy and completeness. - Ability to prepare records in accordance with detailed instructions. - Ability to work effectively with co-workers and patients. - Ability to communicate clearly. Requirements - High school diploma or GED. - Two years experience in healthcare organization. - One year of experience directly involving third payers and insurance companies. - CPC-A or CPC through AAPC preferred but not prerequisite. Benefits - Excellent pay and benefits including paid holidays, PTO, and sick time. - Medical, dental, and vision insurance. - Short & long-term disability. - Employee assistance program. - Company paid life insurance. - Pre-paid legal and identity theft protection. - Pet insurance. - 401k offered.

Role Description REFERRAL CLERK needed full time for busy medical practice in Myrtle Beach. Remote position. Must have excellent computer and customer service skills. Experience with processing patient referrals. Cardiology background a plus. Hours are MON.-THURS. 7:45AM-5:15PM & FRI. 8AM-12PM. No nights or weekends! GENERAL SUMMARY OF DUTIES: - Works with physicians and nurses to ensure smooth workflow in scheduling of patient appointments and procedures. SUPERVISION RECEIVED: - Team Leader/Operations Manager SUPERVISION EXERCISED: - None. ESSENTIAL FUNCTIONS: - Greets customers in polite, prompt, helpful manner and provides any necessary instructions/directions. - Completes necessary paperwork such as referral forms, authorization forms. - Uses computer system to generate information necessary for scheduling appointments. - Good organizational and record keeping skills, legible handwriting. - Maintains clean, orderly waiting area including work area. - Answers phones in pleasant manner and deals with customer needs expeditiously. - Supplements office staff as reception tasks permit by assisting with photocopying, computer input/typing, and scheduling laboratory work as directed. Qualifications - High school diploma or GED. - Minimum of one year experience in customer service setting, preferably six months receptionist experience in health care setting and experience with office equipment. Requirements - 50 wpm typing skill preferred. Abilities - Ability to communicate clearly in person and on the phone and establish/maintain cooperative relationships with patients, families, physicians, staff and other customers. - Ability to organize and prioritize tasks effectively. - Ability to read, understand and follow oral written instructions. - Ability to multi-task. Environmental/Working Conditions - Office setting, well-ventilated and well lighted. Physical Demands - Sitting for 7-8 hours/day. - Requires eye-hand coordination, finger dexterity. - Vision must be corrected to 20/20 and hearing must be in normal range. - Candidate must be able to view computer screens for long periods. - Occasional stress related to workload and customers with problems. Benefits - Excellent pay and benefits including paid holidays, PTO and sick time, medical, dental, vision, short-term and long-term disability, company paid life insurance, employee assistance program, pre-paid legal, identity theft, and 401k offered.