Medical Policy Specialist jobs in Scranton, PA

Description

POSITION SUMMARY

The Medical Payment & Accounts Receivable Specialist provides financial, administrative and clerical services to ensure accuracy and efficiency of billing operations. This position performs payment posting, insurance denial posting and AR follow up, insurance submission, patient refund preparation, prepares deposits and other AR tasks.
 

Work is typically performed in an office environment, but this position has the option to work from home but may also be needed onsite for projects or team meetings from time to time. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. 

Requirements

ESSENTIAL JOB DUTIES and FUNCTIONS

While living and demonstrating our Core Values, the Medical Payment & Accounts Receivable Specialist will:

• Post all mail and EFT insurance and personal payments to patient’s accounts
• Post denials to patient accounts and follow up with payer
• Transfer copay/co-insurance and deductible balances to patient responsibility
• Reconciliation of daily deposits
• Perform remote bank deposit for checks received in the mail
• Knowledge of EOB’s, EFT’s and ERA’s
• Analyze EOB’s, balance healthcare insurance and patient payments
• Perform adjustments and credits to medical accounts as needed
• Follow up on outstanding accounts receivable, focusing on maintaining aged receivables within 90 days of days outstanding. Includes researching aged account reports, outstanding “to-do” list, and processing problematic EOB’s
• Make all necessary corrections in the billing system. Research and resolve claims rejected by payer
• Use online Healthcare databases and other resources for verification and claim status
• Deliver the highest quality medical customer service to healthcare providers and internal providers
• Assist other members of the team with other projects as needed
• Research outstanding credit balances and prepare requests for refunds 

REQUIRED QUALIFICATION

• High school degree or equivalent 
• 1 - 3 years medical billing/claims experience
• Knowledge of EOBs, EFTs and ERAs
• Experience in CPT codes and ICD 10 coding preferred 
• Experience with electronic medical records preferred
• FQHC billing and payment posting preferred, but will train the right candidate
• Medent experience preferred 
• Knowledge of Microsoft Office software
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities
• Accurate and precise attention to detail
• Excellent verbal and written communication skills
• Able to work both independently and as part of a team