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Hanger, Inc. logo
Hanger, Inc.

Empowering Human Potential

Priority Claims Specialist III

Claims SpecialistClaims SpecialistOtherRemoteSeniorTeam 5,001-10,000Since 1861H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

94 days ago

Salary

$17 - $26 / hour

Seniority

Senior

High School5 yrs expEnglish

Job Description

Priority Claims Specialist III

Hanger, Inc.

• Ensure payment for services provided is accurate, timely and fully documented. • Provide efficient cash collection through excellent reimbursement practices while ensuring compliance with relevant laws, regulations and established Hanger policies and compliance programs. • Maintain exceptional support and communication with all partners, internal and external. • Maintain a working knowledge and understanding of DMEOPS CPT and ICD-10 codes. • Utilize the company billing and collections system to identify and resolve any claims that have been unpaid, short paid and/or denied. • Review EOB's and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms. • Follow up with insurance companies by online portal, phone, email and/or fax. • Identify billing errors and submitted corrected claims insurance carriers. • Provide timely and accurate follow up on accounts until they are resolved. • File and follow up on appeals and disputes. • Communicate identified AR issues that may cause payment delays or write offs to management. • Document all findings with clear and concise detail. • Research insurance guidelines and manuals for additional information. • Perform adjustments in the system as needed. • Submit medical records upon request. • Resolve outstanding accounts receivable problems. • Respond to and resolve inquiries from customers or external collection resources. • Review, monitor and resolve assigned encounters and all assigned reports. • Identify issues attributing to account delinquency and discuss them with management as needed. • Provide timely follow-up on all tasks. • Effective communication with Patient Care Clinics related to collection efforts. • Complete, review, and research any deficiency to ensure that any deficiency is properly addressed and resolved.

Job Requirements

  • Minimum High school education or equivalent
  • 5+ years of related experience to include at least one of the following areas: Insurance reimbursement, medical policy, payor appeal requirements or patient collection laws.
  • Experience in a medical office.
  • Experience with NextGen and/or OnBase preferred.
  • Attention to detail with the ability to quickly identify trends.
  • Strong communication and interpersonal skills.
  • Working knowledge of appeals, reimbursement, Local Coverage Determinations (LCDs), and policy articles.
  • Working knowledge of medical terminology.
  • Self-starter / take initiative to proactively resolve problems.
  • Ability to multi-task.
  • Strong sense of personal accountability to meet deadlines.
  • Working knowledge of MS Office suite programs.
  • Working knowledge of Electronic Health Records (EHR); such as, OPS and NextGen.
  • Demonstrated ability to pull data and migrate into online records management systems such as OnBase;
  • Demonstrate high ethical standards regarding confidential patient and billing information.

Benefits

  • Competitive Compensation Packages
  • 8 Paid National Holidays & 4 additional Floating Holidays
  • PTO that includes Vacation and Sick time
  • Medical, Dental, and Vision Benefits
  • 401k Savings and Retirement Plan
  • Paid Parental Bonding Leave for New Parents
  • Generous Employee Referral Bonus Program
  • Mentorship Programs- Mentor and Mentee
  • Student Loan Repayment Assistance by Location
  • Regional & National traveling CPO/CO/CP opportunities
  • Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest

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