Appeal Resolution Specialist jobs in South Carolina

We are in search of an experienced Medical Biller to join our dynamic team of individuals. The applicant must be self motivated health care professionals who share in our vision for high quality, affordable, accessible health care. We set high industry standards and provide a positive and supportive work environment. We believe quality patient care starts from health care professionals who care and embody the strength of personal character and high moral and ethical conduct.

This role is 100% onsite.

Duties include:

-Verify and audit chart and coding discrepancies

-Timely submission of clean electronic claims

-Posting of insurance and patient payments

-Review claim ERA, Manage denials, correct claims and resubmit per insurance guidelines

-Insurance aging and follow up.

-Appeals and Resolutions

-Provider Credentialing

-Monitor various payer websites for guideline updates and report them to your manager

-Uphold Medicare and HIPAA compliance guidelines in relation to billing, collections, and PHI

-Exhibit professionalism in communication with patients, clients, insurance companies and team members at all times.

Required Qualifications:

-Ability to work independently, handle multiple tasks simultaneously and exercise good judgment

-Key Responsibilities, Process Claims, Assess denial reasons, Provide resolutions, and Insurance A/R

-Use EHR system reports and Standard Operation Procedures to work assigned claim steps and gather supporting information

--Strong decision-making and organizational skills; with excellent verbal and written communications

-Ability to think and work effectively under pressure and accurately prioritize and complete tasks timely

-Minimum 3-5years detailed knowledge of medical claims management -associate or bachelor’s degree a plus, as it applies to Healthcare Industry Standard Operating Procedures

-Working knowledge of and the ability to efficiently operate all applicable computer software applications (Outlook, Word, Excel and EMR software)

Job Type: Full-time

Pay: $20.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work setting:

• Private practice

Education:

• Associate (Preferred)

Experience:

• ICD-10: 3 years (Preferred)
• Medical Billing: 3 years (Required)

Work Location: In person