New
Medical Biller
TEKsystems | |
$58,240.00 - $59,000.00 / yr | |
life insurance, sick time, 401(k), retirement plan | |
United States, Missouri, St. Louis | |
Sep 20, 2024 | |
*Description:*
Tek Systems is looking for someone to join a team of medical claims processors who advocate for members while maintaining the policies and procedures required of an Employee Retirement Income Security Act (ERISA) benefit plan. The Medical Claims Processor is responsible for adjudicating medical claims timely and accurately while providing customer service to claimants and providers. This is an in-office position where the candidate would work closely with peers and an assistant supervisor and would report to an immediate supervisor and/or the Director of the Welfare Fund. Responsibilities: *Work closely with peers to ensure the goals and duties of the Claims Department are met efficiently, accurately, and pleasantly. Uphold the mindset of working together as a team. *Review and analyze medical claims for eligibility and benefits. *Adjudicate medical claims per the Fund's benefit plan. *Maintain knowledge of all Fund benefits. *Customer Service *Maintain adequate telephone coverage by communicating and working with peers' schedules. *Take calls from providers and their billing representatives. Provide eligibility and confirm benefits. Provide claim status. Assist with problems or questions and provide resources. *Take calls from participants and their families. Assist with their inquiries and advocate for their healthcare needs. Ensure members receive all available benefits to which they are entitled to under the plan. Contact providers or others on their behalf when needed. *Work directly with vendors (medical, prescription, dental, vision, and others) to coordinate work efforts and address any issues/concerns. *Comply with the Health Insurance Portability and Accountability Act (HIPAA). *Adaptability and willingness to cross train, multitask, and assist coworkers and the Fund where and when needed. *Organize, prioritize, route, and ensure resolution of matters presented to you (whether presented in person, by mail, fax, email or otherwise). *Requirements:* *High School graduate or GED equivalent. *2+ years of medical billing or collections experience *Working knowledge of healthcare industry, insurance claims, and the associated medical terminology. *Strong customer service aptitude. *Working knowledge of Microsoft Office and Adobe Acrobat products. *Strong communication skills *Description:* * * Potential candidates will need to function in a high phone call volume setting* All calls will need to be answered within 30 SECONDS after the first ring! * Participate in an extensive paid training program encompassing areas of customer service, computer applications, policy, and procedure * Manage inbound calls from our members to verify eligibility and coordinate non-emergent transportation utilizing company system * Listen and obtain information from callers in a professional, systematic and organized manner * Acquire and maintain in-depth knowledge of, and adhere to, established Protocols and Procedures * Assume responsibility for self-development and career progression * Maintain flexibility in efforts to provide quality service to our members and help achieve business and operational goals * Maintain acceptable abandoned call rates, average handle time, productivity percentage, and attendance; as outlined by company standards * May be required to work weekends and/or holidays, as needed * Maintain confidential information standards within a fast paced environment * Relate to a diversity of requests * Identify customer needs and circumstances * Tactfully question and obtain necessary information * Recognize, handle, and refer situations of an emergent nature *Hours:* * 8:00am-4:30 MST *Qualifications:* * 3+ years of call center experience in a healthcare setting * Preference for medical transportation scheduling * Ability to work onsite 5 days per week; Regular attendance is required * High School Diploma Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. |