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Medical Claims Specialist

Renton, WA 98057

Employment Type: Temporary Job Category: None Job Number: 246796 Pay Rate: $19.00/hour
Do you have a minimum of 6 months previous healthcare billing experience? Do you have previous medical claims review experience? Are you detail oriented and have the ability to multi-task to get the job done? If so, PACE Staffing Network wants to speak with you about a great new opportunity with one of our Clients in Renton!

Our Client, one of the largest healthcare networks in state of Washington, is looking for an experience medical biller to join their team and help research and clear adjustments! This is an excellent chance to get your foot in the door with an outstanding company with growth potential.

Successful applicants will have strong communication skills, be advanced in Microsoft Excel and have a well rounded knowledge of medical billing/claims processes. If you feel like this describes you, please APPLY NOW!

Pay: $19 per hr
Location: Renton, WA
Length of Assignment: 3+ months
**Pre-employment drug screen required**
**Pre-employment background check required**

Job Duties:
  • Review charges that may need to be routed to a different account type, create new account types as needed, and add (or link) the correct coverage(s) to the new accounts.
  • Review charges for any coverage errors and research available resources to determine correct information needed to clear the charge; edit as appropriate.
  • Resolve all pre-processing claim edits that indicate errors needing correction.
  • Assimilate and operationalize all quarterly/yearly updates to each payers billing rules, guidelines, exceptions, and carve-outs, making sure we' ve captured any changes that may require building additional charge edits or claim edits.
  • Process all account merge requests in a timely manner when its determined there are duplicate patient accounts in our EPIC billing system.
  • Complete retro adjudication process using assigned work queues when new coverages are added to patient accounts by other areas, including reviewing for incorrect payments from insurance or patient, and rebill charges accordingly.
  • Update or correct patient registration/demographics on accounts in the EPIC billing system.
  • Update/edit charge entry detail for Medicare claims that have been corrected and need to be resubmitted electronically.
  • Research and navigate a variety of databases to obtain/verify claim/eligibility information via payer websites and/or confer with payers by phone.
  • Process claim attachments and secondary claims.
  • Review and identify corrected claims to ensure that all necessary documentation is compiled for submission to payers.
  • Answer questions regarding team functions.
  • Conduct written and oral communications with insurance follow up teams/third party payers/others to resolve claims issues.
  • Compile documents using correct filing order based on proper application of COB rules.
  • Link coverage additions, deletions, corrections across all service areas in order to prevent future claim edits from firing.
  • Perform other duties, as assigned

Job Requirements:
  • Minimum 6 months experience in medical billing
  • Experience in a healthcare environment preferred
  • Advanced Excel skills
  • Strong analytical skills
  • Excellent written and verbal communication skills
  • Ability to prioritize workload and meet quality and production standards
  • Ability to work well with a variety of people and be a team player
  • Strong customer service background or approach to work
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