Claim / Medical Biller / Eligibility specialist
Medical Recruiting Strategies Morgantown, WV
- Expired: over a month ago. Applications are no longer accepted.
• High School diploma or equivalent
• 3-5 years’ experience in a customer service setting preferably in a call center environment; Previous experience in the PBM and or Healthcare Industry preferred
• Computer proficiency in MS Office applications, with database experience preferred
• Health insurance claims or patient accounting experience preferred
• Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred
• Detail oriented with good analytical skills
• Ability to manage multiple priorities and meet deadlines
• Excellent written and verbal communication skills, demonstrated ability to communicate with others at all levels
• Excellent customer skills-patience to explain details and processes repeatedly, excellent phone presentation skills
• Demonstrated ability to handle challenging customers in a professional manner, ability to adapt in a dynamic work environment and make decisions with minimal supervision
• Advance problem solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions
• Ability to work a flexible schedule
Top Trait/Skills “buzz words’ you like to see on a resume: Insurance/Benefits verification, pharmacy tech, customer service, payer research, prior authorization, medical billing
Top Behavioral Traits: Attention to Detail, Organized, Ability to multi-task, Reliable attendance
Resume Review/Interview Process: Resume(s) reviewed by hiring manager and program manager. If resume fits position needs, interview will be conducted by hiring manager and other UBC management personnel via phone and/or in person.
JOB DESCRIPTION: The primary purpose of this position is to provide day-to-day case management oversight and coordination of assigned caseload to ensure parties responsible for tasks are completing them timely, as well as act as a primary resource for patients, healthcare providers and field reimbursement. The Eligibility Specialist is responsible for ensuring prior authorizations, reauthorizations and appeals are obtained timely, as well as ensuring accurate documentation of payer information and patient status. In addition, the Eligibility Specialist is responsible for completing a pre-screen to determine eligibility for additional services such as injection services, co-pay mitigation, and patient assistance programs (PAP), if applicable.