You are extremely detail-oriented and have a background in medical billing. In this role, you will be responsiblefor reviewing and conducting claim status on claims for all insurance carriers for specialty physician practices. You will maintain accuracy and production to ensure accounts receivable is being processed effectively.
iSalus Healthcare, a division of EverCommerce, is a leading provider of EMR and Practice Management software and services for the specialty physician practice marketplace. We provide highly configurable, customized solutions for specialty physician practices, along with Revenue Cycle Management solutions and a unique Chronic Care Management offering for clients nationwide.
Our office is located in Oak Ridge, TN, but our teams are all working remotely for the foreseeable future. It's preferred, but not required, that this person will be based within a commutable distance of our office.
- Conducts claim status using clearinghouses, payer web portals, fax, spreadsheet, and phone processes.
- Reviews Medicare claims to identify potential problem areas for each assigned physician practice and payer.
- Reviews and works Medicaid claims to identify potential problem areas for each assigned physician practice and payer.
- Reviews and works Workers' Compensation and No-Fault Claims for to identify potential problem areas for each assigned facility.
- Reviews and works commercial and managed care claims as required.
- Contacts and follows up on Medicare, Medicaid, Blue Cross Blue Shield, Managed Care, and Commercial insurances to inquire on unpaid claims as required for claim to pay.
- Assembles and forwards appropriate documentation to the Team Lead for provider related or claim spec issues.
- Assembles and forwards appropriate documentation to the appeals unit or to the coding unit for dispute.
- Posts denials and adjustments, and files claims as needed.
- Works from worklists of assigned AR to ensure timely reviews.
- Performs all duties as directed by Team Lead or Director of RCM Services.
Skills & Qualification:
- Reports any consistent errors identified during review that affect claims from being processed correctly that may include carrier/billing system issues, filing address, eligibility, payment address, etc.
- Presents to Team Lead unusual circumstances that may include adjustments, denials, fee schedules, claims, contracts, etc.
Benefits & Perks:
- High school diploma or equivalent required;
- Previous medical billing experience with primary emphasis on collections from Government or Managed Care programs;
- Strong computer skills;
- Excellent communication skills both oral and written;
- Ability to meet deadlines and work overtime as needed.
- Competitive salary
- Robust medical, dental, and vision benefits
- 401(k) with match
- Public transportation reimbursement
- Gym stipend
- Start with 17 vacation days, 8 standard holidays, 2 floating holidays, and day off to volunteer each year
We are building an extraordinary team and looking for talented, passionate, and authentic people to join us.
EverCommerce is an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. We look forward to reviewing your credentials and getting to know more about your experience!