Accounts Payable Assistant (000282)

Duties:
Job Summary:
Exposure to general ledger. Ability to review, audit and process invoices, and identify errors.

Job Responsibilities:
N/A
Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed using multiple systems and platforms.
Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&Ps, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.)
Research claims that may have paid incorrectly and communicate findings for adjustment; Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts etc.) ensuring that all relevant information is considered.
Advise business partners of findings outcome if their input is needed to help fix the issue.
Communicate through correspondence with providers regarding claim payment or additional required information in a clear and concise manner.
Process the adjustment of claims in a timely manner, according to established timelines.
Remain current with changes/updates in claims processing, as well as updates to coding systems.
Maintain accurate records of all claims processed, including notes on actions taken.
Generate reports on claim activity as requested.
Respond to audits of claims processed.
Able to work independently and exercise good judgment

Skills:
Required Skills & Experience:
Experience with intermediate PC applications.
Must have decision making, problem solving and time management skills with two (2) years of experience.

Preferred Skills & Experience:
N/A

Required Qualifications:
Associate degree preferred. High School Degree or evidence of having passed a High School Equivalency Program required.
Minimum 3 years of claims operations experience in a healthcare field, with knowledge of integrated claims processing required.
Strong Analytical Skills
Experience using a PC and claim adjudication system(s)
Experience using Customer Relationship Management (CRM) software; SalesForce a plus
Experience working with large data and spreadsheets; skilled in Excel and Word
Excellent communication skills Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes
Additional Qualification.Processing of Medical Claim Forms (HCFA, UB04)Knowledge of Medical Terminology

Knowledge of HIPPA Guidelines regarding Protected Health Information

Data Entry of Provider Claim/Billing information
Experience handling or familiarity with Medical Claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators.

Education:
Required Education:
High School Diploma.
OR
GED.

Preferred Education:
N/A

Required Certifications & Licensure:
N/A

Preferred Certifications & Licensure:
N/A
null

Languages:
English Read Write Speak