[Hiring] Claims Processor II @Medical University of South Carolina

Role Description

Account maintenance including:

• Updating registration
• Authorization issues
• Identifying charge correction
• Processing adjustments as needed
• Denial follow-up according to payer rules and departmental policies

Use electronic billing system appropriately to:

• Follow up on outstanding denied claims and all no response claims
• Correct claims in electronic billing system for missing or invalid insurance or patient information
• Place account on hold if unable to resolve

Follow up on denied or no response claims by:

• Calling third party payers or using payer websites
• Gathering information from patients or other areas to resolve outstanding claims
• Researching accounts to take appropriate action necessary to resolve

Keep management aware of issues and trends to:

• Enhance operations
• Escalate slow-pay issues to managerial level when necessary

Maintain:

• 95% quality standards on account follow-up and activity
• Productivity standard as set forth by management team

Additional responsibilities include:

• Serving as preceptor for Physician Patient Accounting and receiving STAR certification
• Cross-covering on any team as directed by management team or Director of Physician Patient Accounting
• Providing payer feedback during team meetings to encourage collaboration among groups
• Collaborating with other claims processor II to review and enhance existing workflows supporting training PPA team members
• Other duties as assigned

Qualifications

• Associates Degree preferred
• 2 years billing and insurance follow-up or 4 years of billing and insurance follow-up in a hospital or physician office setting required
• Thorough working knowledge of insurance terminology, CPT coding, and billing rules required
• Knowledge of Epic preferred

Requirements

• Able to prioritize work on a daily basis
• Requires independent judgment in handling patient accounts
• Direct supervision available on a daily basis as conditions may require

Benefits

• Working with energetic and enthusiastic individuals

Company Description

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.