Med Admin

Mt. Pleasant, SC 29486

Posted: 09/20/2019 Industry: Admin - Clerical Job Number: 11831 Pay Rate: 14.00 - 15.00

Local Mt. Pleasant, SC healthcare facility has an immediate need for an Appeals Claims Specialist.

Appeals Claims Specialist

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Analyze and process a variety health claim forms; UB-04, CMS-1500 or ADA

Follow claims adjudication process to assure that all claims are adjudicated in accordance with CMS rules and regulations

Review Medicare, Medicaid and Commercial services for appropriateness of charges

Authorize claim payments within established limits; otherwise forward to Claims Manager

Process refunds and letters of dual coverage (when applicable)

Identify process improvement opportunities within the claim department and recommend system enhancements

Handles any additional responsibility which may be assigned

QUALIFICATIONS AND REQUIREMENTS:

High School Diploma or GED, some college coursework preferred

1 year of experience with Medical Billing

Ability to communicate effectively verbally and in writing and be able to speak professionally with patients and insurance companies

Ability to proactively resolve issues

Creative problem-solving skills

Ability to organize and set priorities according to situation all demands

Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications

Job Type: Full-time

Salary: $14.00 to $15.00 /hour

Experience:

Medical Billing: 1 year (Required)

Medical Coding: 1 year (Preferred)

Location: Mt. Pleasant, SC

Drug free workplace and a criminal background check is required.

Never a fee.

EOE.

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