GBS Convergent Solutions.

  • Fairlawn, OH


  • Long-term.

  • Full-time.

Claims Processor

Staff member will be onsite in Fairlawn, OH

POSITION SUMMARY

Processes paper and electronic claims. Responsible for working claim edits, reports, correspondence, and indexing related to the claim’s department duties.

NECESSARY DUTIES AND OBLIGATIONS

  • Guarantee primary paper claims have produced for processing; prepare for mailing with any essential attachments
  • Make sure secondary and tertiary claims have generated for processing; prepare for mailing with required attachments’ includes submitting MCD tertiary claim online with payer
  • Make sure electronic claim files are created and published
  • Work internal claim rejections
  • Work external Clearinghouse rejections
  • Work external payer rejections
  • Produce and keep claim reports for clients and management
  • Address possible custom modifies, with supervisor, related to all procedures for procedure improvements
  • Work on correspondence, scanning and indexing of claims
  • Carries out other tasks as appointed and/or presume additional obligations as required

QUALIFICATIONS (Understanding, Skills, and Capability Requirements)

  • High School diploma or equivalent
  • Formal post high school medical billing training program chosen or; Minimum of 2 years relevant experience
  • Exceptional communication abilities needed both composed and verbal, with the ability to interact efficiently with administrative staff, physicians, clients, households, employees, as well as external clients; Must keep open interaction with senior management and staff
  • Must be detailed oriented, arranged and have remarkable ability in prioritizing tasks
  • Must be able to work versatile hours when needed and periodic extended hours when required
  • Efficiently cope with change
  • Orchestrate several activities at once to accomplish an objective; uses resources effectively and efficiently; detail oriented
  • Able to keep confidentiality within a HIPAA safe and secure environment

ENVIRONMENTAL/WORKING CONDITIONS

  • Normal office environment
  • Sit for long durations of time; manual mastery, use a calculator and to operate a computer system keyboard; regular movement needed to access files; bending, stooping, strolling and raising required
  • Must be able to work flexible hours when essential with periodic prolonged hours when needed
  • Compulsory overtime at month-end

SUPERVISORY DUTIES

Does this job have supervisory responsibilities?

ApplicantPro.