<p>Passionate, driven people dedicated to making a difference in healthcare.</p> <p>SpecialtyCare is a leading provider of clinical services to hospitals. We partner with hospitals to drive, sustain, and accelerate high performance. We offer a portfolio of solutions that include neuromonitoring, perfusion, surgical assist, autotransfusion, minimally invasive surgical support, and sterile processing. SpecialtyCare's clinicians focus their efforts to improve operational efficiencies, improve outcomes, and maintain exceptional levels of satisfaction. We compete on results.</p> <p>The Position</p> <p>This position is responsible for analyzing and following up on billed medical claims to determine the appropriate course of action to resolve automobile accident and workers compensation claims.</p> <ul> <li>Problem-solve denied claims in a timely manner by contacting insurance adjustors or carrier to obtain information to rebill claims as necessary </li><li>Write timely appeals to insurance companies to overturn denied or short paid claims and consistently follow up to ensure payment </li><li>Research and re-bill claims as necessary when returned for incomplete information </li><li>Identify and manage authorization, insurance changes, denials and appeals </li><li>Communicate professionally and effectively with patients, insurance companies, clinical personnel, and legal offices </li><li>Receive inbound calls to receive and process credit card payments. </li><li>Generate invoices and credit memos as appropriate. </li><li>Research and resolve any disputes related to services/products provided. </li><li>Contact customers via telephone, e-mail and/or mail to resolve past due balances. </li><li>Provide detailed documentation of collection efforts on a monthly basis and as requested. </li><li>Represent SpecialtyCare with the highest level of professionalism by providing our clients with exceptional customer service. </li><li>Live the SpecialtyCare Values - Integrity, Teamwork, Care & Improvement. </li><li>Perform other duties as assigned. </li></ul> <p>Education:</p> <p>High School Diploma or G.E.D. equivalent.</p> <p>Experience:</p> <ul> <li>1 year related experience and/or training </li><li>Equivalent combination of education and experience. </li><li>Experience working with PeopleSoft and NextGen helpful. </li></ul> <p>Knowledge and Skills:</p> <ul> <li>Strong understanding of UB's, 1500's, Remittance Advice (RA's). </li><li>Ability to read and understand EOB's (Explanation of Benefits). </li><li>Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume </li><li>Good understanding of debits and credits and the billing process. </li><li>Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. </li><li>Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. </li><li>Proficient with a computer and good knowledge and understanding of MS office programs, and email. </li><li>Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. </li><li>Ability to write reports, business correspondence, and procedure manuals. </li><li>Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. </li></ul>