Hanger, Inc.
Priority Claims Specialist III
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Job Description
- Req#: 30169
Employer Industry: Orthotics and Prosthetics Services
Why consider this job opportunity:
- Salary up to $29.42 per hour, plus an annual bonus of up to 5% of base pay
- Competitive compensation packages with comprehensive benefits
- Flexible work schedules and part-time opportunities available
- 8 paid national holidays and additional floating holidays
- Opportunities for mentorship and student loan repayment assistance
- Chance to contribute to community events and initiatives
What to Expect (Job Responsibilities):
- Review complex claims and patient records, identifying discrepancies in payments made to Medicare providers
- Conduct internal and external data and medical chart reviews to ensure compliance with CMS guidelines
- Prepare complex claims reimbursement submissions and assess claims for risk of denial or audit
- Build and maintain relationships with clinic administration and insurance organizations to support reimbursement processes
- Report anomalies and new trends to supervisors for further analysis
What is Required (Qualifications):
- High school education or equivalent
- Minimum of 4 years of related experience in payor policies, reimbursement, and medical policy
- Strong communication and interpersonal skills
- Working knowledge of Medicare audits, appeals, and reimbursement processes
- Proficiency in MS Office suite programs and Electronic Health Records (EHR)
How to Stand Out (Preferred Qualifications):
- Bachelor’s degree in a relevant field
- Licensed Medicare auditor or Certified Medical Audit Specialist
- Experience in training staff on reimbursement issues
- Strong attention to detail and ability to identify trends quickly
- Demonstrated ability to innovate and influence change in processes
#Orthotics #Prosthetics #Healthcare #CareerOpportunity #RemoteWorkAbout the company
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