Claims Specialist Apprentice - Journal Center
TriCore Reference Laboratories
Date: 3 days ago
City: Albuquerque, NM
Contract type: Contractor
Scheduled Shift: Monday-Friday 8:00AM-5:00PM and other shifts as needed.
Location: Journal Center
Job Summary
This position starts with an eight-week paid training program that is designed to grow your skills in customer service.
The training program provides a paid opportunity for you to learn customer service and revenue operations skills. You will learn best-practices used in the business office focused on resolving patient accounts. Upon completion of the training program, you will be transitioned into a full-time role of preforming customer service on patient accounts.
Essential Functions
High School Diploma or equivalent
Minimum Experience
No experience required.
Other Requirements
Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications.
Must be able to type 30 words per minute (typing test required)
Preferred
One year in a healthcare setting.
Location: Journal Center
Job Summary
This position starts with an eight-week paid training program that is designed to grow your skills in customer service.
The training program provides a paid opportunity for you to learn customer service and revenue operations skills. You will learn best-practices used in the business office focused on resolving patient accounts. Upon completion of the training program, you will be transitioned into a full-time role of preforming customer service on patient accounts.
Essential Functions
- Follow-up on basic claim denials for assigned accounts or from account receivable reports focusing attention on accounts over 60 days from primary and secondary payors working to resolution of account while gradually progressing to higher complexity denials.
- Perform research of denials and unpaid claims making appropriate corrections until worked to resolution to include phone call, claims resubmission, appeal or reconsideration.
- Complete BBP report to account resolution.
- Demonstrate a working knowledge of basic healthcare contractual obligations such as claim filing limits, medical necessity and dual coverage through accurate and timely claims filing while progressively increasing understanding of payer policies and procedures.
- Accurately verify eligibility on patient accounts using online insurance resources.
- Work payer correspondence received.
- Researches adjustments and pulls all necessary backup to support adjustments.
- Communicate effectively and professionally to all customers (internal and external) using key words as appropriate.
- Maintain confidentiality of patient and client information. Responsible for following TriCore safety, personnel, and billing department policies. Must participate in training as requested by Supervisor/Manager.
- Meet all Quality Assurance (QA) accuracy and data.
High School Diploma or equivalent
Minimum Experience
No experience required.
Other Requirements
Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications.
Must be able to type 30 words per minute (typing test required)
Preferred
One year in a healthcare setting.
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