Hanger Clinic
Priority Claims Specialist III
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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, plus an annual bonus: up to 5% of base pay depending on bonus criteria
- Competitive compensation packages and comprehensive benefits, including medical, dental, and vision insurance
- 8 paid national holidays and 4 additional floating holidays
- Opportunities for professional development through mentorship programs and student loan repayment assistance
- Flexible work schedules and part-time opportunities available
- Chance to make a positive impact on patient care and outcomes
What to Expect (Job Responsibilities):
- Review complex claims, patient records, and billing practices to identify discrepancies or errors in payments to Medicare providers
- Conduct internal and external data reviews to ensure compliance with CMS guidelines and medical policies
- Develop and maintain professional relationships with colleagues, physicians, and regulatory staff
- Prepare complex claims reimbursement submissions and assess claims for risk of denial or audit
- Serve as a resource for clinic administration regarding reimbursement and managed care issues
What is Required (Qualifications):
- High school education or equivalent
- Minimum of 4 years of related experience in payer policies, reimbursement, and medical policy
- Strong communication and interpersonal skills
- Working knowledge of Medicare audit, appeals, and reimbursement processes
- Ability to multi-task and meet deadlines with strong attention to detail
How to Stand Out (Preferred Qualifications):
- Bachelor’s degree
- Licensed Medicare auditor or Certified Medical Audit Specialist
- Experience with Electronic Health Records (EHR) systems
- Knowledge of Local Coverage Determinations (LCDs) and policy articles
- Proven ability to pull data and manage online records systems
#OrthoticProsthetic #HealthcareCareers #RemoteWork #CompetitiveCompensation #PatientCare
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Hanger, Inc. (NYSE: HNGR is a leading national provider of products and services that assist in enhancing or restoring the physical capabilities of patients with disabilities or injuries that is headquartered in Austin, TX.
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