Hanger
Priority Claims Specialist III
This job is now closed
Job Description
- Req#: 30169
Employer Industry: Orthotics and Prosthetics Services
Why consider this job opportunity:
- Pay range of $19.62 to $29.42 per hour + annual bonus: up to 5% of base pay depending on bonus criteria
- Competitive compensation packages with generous employee referral bonus program
- 8 paid national holidays and 4 additional floating holidays
- Medical, dental, and vision benefits, along with 401k savings and retirement plan
- Flexible work schedules and part-time opportunities available
- Opportunities for mentorship and participation in community events
What to Expect (Job Responsibilities):
- Review complex claims, patient records, and billing practices to identify discrepancies in Medicare payments
- Perform internal and external data reviews to ensure compliance with CMS guidelines and medical policies
- Prepare complex claims reimbursement submissions and assess claims for risk of denial or audit
- Maintain relationships with clinic administration and managed care organizations to facilitate reimbursement processes
- Conduct analytical research on pricing, reimbursement, and claim appeals, providing expertise in these areas
What is Required (Qualifications):
- High school education or equivalent
- Minimum of 4 years of related experience in payer policies related to reimbursement and medical policy
- Strong communication and interpersonal skills
- Working knowledge of Medicare audits, appeals, and reimbursement policies
- Ability to multi-task and meet deadlines with attention to detail
How to Stand Out (Preferred Qualifications):
- Bachelor’s degree
- Licensed Medicare auditor or Certified Medical Audit Specialist
- Working knowledge of Electronic Health Records (EHR) systems
- Demonstrated ability to pull data and manage records in online systems
- Experience in fostering collaboration and continuous innovation in work processes
#Orthotics #Prosthetics #HealthcareJobs #RemoteWork #CareerGrowthAbout the company
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