Coding Representative - Medical I

Coding Representative - Medical I - Monday to Friday, 7:00AM - 3:30PM Central

Pay range: $23.48 - $27/hour

Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation.

Benefits information:
We are proud to offer best-in-class benefits and programs to support employees and their families in living healthy, happy lives. Our pay and benefit plans have been designed to promote employee health in all respects - physical, financial, and developmental. Depending on whether it is a part-time or full-time position, some of the benefits offered may include:

• Day 1 Medical, supplemental health, dental & vision for FT employees who work 30+ hours
• Best-in-class well-being programs
• Annual, no-cost health assessment program Blueprint for Wellness
• healthyMINDS mental health program
• Vacation and Health/Flex Time
• 6 Holidays plus 1 "MyDay" off
• FinFit financial coaching and services
• 401(k) pre-tax and/or Roth IRA with company match up to 5% after 12 months of service
• Employee stock purchase plan
• Life and disability insurance, plus buy-up option

• Flexible Spending Accounts

• Matching gifts program
• Education assistance through MyQuest for Education
• Career advancement opportunities
• and so much more!

Performs various clerical functions as requested by the manager or senior analysts.

Primary Responsibilities:

• Analyzes and applies denials to third party carriers in all media types.
• Complies with departmental Business Rules and Standard Operating Procedures.
• Focuses efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt.
• Interprets explanation of benefits for appropriate follow up action.
• Utilizes automation tools to verify eligibility, claim status and/or to obtain better billing information.
• Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication.
• Reviews and researches denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing.
• Communicates and collaborates with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding.
• Conducts data entry and re-work for adjudication of claims.
• Works on various other projects as needed.
• Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance.
• This position is full-time (40 hours/week) Monday - Friday. It may be necessary, given the business need, to work occasional overtime and/or weekends or holidays.

Required Qualifications:

• Must be 18 years of age or older
• 1+ years of experience in Accounts Receivable, Billing, or Customer Service within the healthcare insurance or healthcare industry
• 1+ years of experience in Quest Billing system (QBS) and / OR Web Billing System (WBS)
• Ability using computer and Windows PC applications, such as Outlook, Excel, instant message, video conferencing
• Keyboard and navigation skills and ability to learn new computer programs
• Ability to work an eight hour shift between 7:00 AM and 4:30 PM EST, Monday through Friday, with the ability to work overtime based on business needs
• Reside within Eastern Standard Time Zone

Preferred Qualifications:

• Medical terminology acumen and experience

Soft Skills:

• Previous work experience in a fast paced environment requiring strong multi-tasking and problem solving skills
• Ability to resolve calls, avoiding escalated complaints
• Ability to exhibit empathy and be courteous to callers
• Ability to triage and handle escalated situations
• Ability to work in a fast-paced environment
• Ability to adapt to changes
• Ability to develop and maintain client relationships

Education

• High School Diploma or Equivalent (Required)