Error Processing Specialist - Medical AR Management Services, LLC

Summary: The Error Processing Specialist performs front end errors and back end error resolution functions for all claims rejected by the billing clearing house or insurance carriers. All rejections are reviewed and resolved to accurately bill for services performed. The error resolution elements can include demographic, insurance, and coverage eligibility.

Essential Duties and Responsibilities include the following: (Other duties may be assigned)

·Resolve and update all data elements into billing systems and clearinghouse. (multiple systems may be required)
·Compare data with source documents to detect errors or discrepancies prior to resubmitting claims
·Perform quality insurance coverage and eligibility verification utilizing provider payors portals to ensure data integrity
·Report and maintain all identified key metrics

Required Qualifications:

·High School graduate or equivalent
·2+ years' experience in healthcare setting
·2+ year experience performing clearinghouse error processing and resolution functions
·Computer proficiency in Microsoft Windows environment
·Ability to type 10,500 KSPH with 95% accuracy
·Strong cognitive skills including analysis, problem solving, and decision making.
·Ability to work collaboratively with other team members to support data quality and integrity initiatives
·Strong organizational skills with a high attention to detail
·Ability to work on multiple assignments concurrently within established timeframes
·Knowledge of Federal, state, and HIPPA privacy regulations.

Preferred Qualifications:

·Clinical and/or Anatomic Pathology accounts receivable experience
·XIFIN and Health Pac software experience a plus
·Waystar formerly known as ZirMed clearinghouse experience a plus
·Online payer portal knowledge such as Palmetto, Availity, TMHP, UHC Link, and Navinet experience a plus

Competency:
To perform the job successfully, an individual should demonstrate the following competencies:

•Organizational- Ability to operate effectively within standard operating procedure; Demonstrate effective verbal, written, and listening skills; Strive to meet and exceed expectations
•Problem Solving- Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics
•Judgement- Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains
•Professionalism- Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments