Back Office Claims Specialist

Are you passionate about helping people make their dreams of owning a business a reality? 


 

Job Description

In this role you will be working closely with our Account Management team, working together to provide a high-touch experience to our clients. You will be responsible for analyzing patient accounts, performing the appropriate steps or actions needed to reprocess unpaid claims, and handling inquiries regarding patient’s accounts. This is a Winston-Salem, NC based position. 

Minimum two years experience preferably in one or more of the following areas: medical billing or hospital coding, as a claims processor, medical claims for an insurance carrier, or clerical/billing experience in a medical office.

  • Enters information necessary for insurance claims such as patient demographic info, insurance ID, diagnosis and treatment code and procedure modifiers. Ensures claim information is complete and accurate.
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
  • Follows up with insurance company on unpaid or rejected claims. Resolves issue and re-submits claims.
  • Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany appeal.
  • Understands managed care authorizations and limits to coverage such as the number of visits.
  • Ability to look up ICD-10 diagnosis and CPT treatment codes from online service or using traditional coding references.
  • Follows HIPAA guidelines in handling patient information.

Qualifications needed:

  • Excellent interpersonal and communication skills.
  • Strong attention to detail.
  • Experience with insurance carriers or a third-party administrator is preferred.
  • Knowledge of basic medical terminology.
  • High level of trustworthiness.
  • Ability to organize and prioritize work in a stressful environment.
  • Ability to work effectively as a member of a team and be self-directed.
  • Superb problem solving skills.
  • Exemplary keyboarding skills

Benefits & Perks:

  • Full time employees are offered standard benefits including health, vision, and dental.
  • Modern, state-of-the-art office buildings
  • Unlimited paid time off
  • Gourmet coffee available to all employees in the office.
  • Free parking in the heart of downtown Winston-Salem or commuter benefits in NYC
  • Access to a full-service gym in the office (NYC, and coming soon in W-S!)
  • Ping-pong and foosball tables in the office- aka a “startup” environment

The Ideal Candidate will be:

  • A go-getter, roll your sleeves up attitude
  • A security-minded individual who exudes the attention to privacy that our providers require.
  • An eagerness to learn and help grow our innovative, impactful startup.

Bonus Points if you:

  • You have experience with medical billing or medical office administration.

Minimum Qualifications:

  • College degree or 4 years work experience in a healthcare related field.

Sound like you?

Send us your email and cover letter to careers@healthybytes.co with the subject: Back Office Claims Specialist.

Looking forward to hearing from you!