Continuous Improvement Specialist jobs in Biloxi, MS

Essential Job Duties:

• Responsible for working and posting claims of patients covered under private and public plans while posting appropriate updates and statuses in the RCM system.

• Work appeals/denials in a timely manner and creates solutions to prevent future denials.

• Research/process credits (recoupments and refunds) to insurance companies and patients as appropriate

• Reviews and analyzes patient accounts to determine accurate levels of coding and other billable services.

• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well.

• Handles precertification procedures pertaining to patients by collecting insurance information and entering information into Prime Suite system.

• Verifies insurance benefits/coverage by contacting insurance companies; obtains insurance information for precertification for procedure; works with insurance company, health care provider & patient to get claims processed & paid.

• Answers patient inquiries in a professional & courteous manner.

• Records benefit and certification information into the applicable computer system and communicates with scheduling in accordance to established work processes.

• Able to utilize and leverage Microsoft Office products (PowerPoint, Excel, Word, Outlook)

• Experience with Modernizing Medicine practice management system and orthopedic billing and collections a plus

• Performs other duties as assigned.

Education:

• High School Diploma or equivalent required.

• 3 - 5 years Healthcare RCM experience related to the described duties.

Additional Requirements:

• Knowledge of medical terminology and procedures, knowledge of health insurance industry practices and/or medical billing procedures.

• Experience with medical scheduling/billing systems preferred.

• Exceptional customer service, interpersonal skills, and communication skills

• Proficiency of electronic records systems preferred. Must have strong data entry skills.

• Must be able to complete tasks with a high-degree of efficiency and accuracy while working in a fast-paced environment with frequent disruptions.

• Must demonstrate ability to analyze data and resolve complex problems.

• Must have the ability to work independently while managing time and workload appropriately.

• Must be able to travel to all clinic locations and work overtime hours as needed.

Job Type: As Needed/ PRN

Remote: None

Experience

• 3 - 5 years: 3 - 5 years Healthcare RCM experience related to the described duties.

Education

• High School or better