Claims Representative

Description

Claims Representative will be responsible for preparing, editing, and submitting insurance claims. Review rejections in clearinghouse and advise management about system errors. Our ideal candidate has knowledge and experience in managing EDI claim submissions and claim mapping.  Attention to detail, accuracy, and effective communication is a desired skillset. Consistently meet or exceed productivity standards, targets, error ratios, and reporting requirements as assigned by the Front End Revenue Cycle Supervisor.

Compass Health Center is a recognized leader in crisis-level mental health, setting the standard for excellence in the PHP/IOP space. Our evidence-based approach (CBT, DBT, ACT) and collaborative, team-based environment make Compass the best place to start or build your career.

Our rapid growth continues to create new opportunities as we continue to push for better and differentiated care for our patients seeking treatment for anxiety, depression, trauma, substance use, and other co-occurring conditions.

Responsibilities Include:

• Reviewing claim billing batches for accuracy and applying edits as necessary
• Submission of prepared claims to clearinghouse, and review of rejections and error responses
• Prepare patient statements
• Perform daily, systematic reviews of work lists to ensure all accounts to be worked are completed
• Demonstrate excellent customer service through oral and written communication in providing assistance/expertise to patients, authorized guarantors, and other external and internal contacts
• Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices
• Provide individual contribution to the overall team effort of achieving the department accounts receivable goals
• Identify opportunities for system and process improvement and submit to management
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
• Assist Revenue Cycle Supervisor with special projects and other duties as assigned, as necessary

Required:

• High School Diploma
• 1 year related work experience
• Knowledge of HIPAA standards
• Excellent communication skills to include oral and written comprehension and expression
• Basic knowledge of medical terminology and billing practices
• Extensive experience and knowledge of PC applications, including Microsoft Office and Excel
• Ability to work independently and to carry out assignments to completion
• Ability to learn and adapt quickly and meet continuous timelines

Desired:

• Associates Degree
• Detail-oriented, good organizational skills, and ability to be self-directed
• Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere
• Flexibility to perform other tasks as needed in an active work environment with changing work needs
• Excellent internal/external customer service skills.