Medical Claims Specialist

NO PATIENT INTERACTION

Address: Rochester Hills, MI 48309

Schedule: Monday - Friday 8am-4:30pm during training and after training the hours are flexible from 7am- 5pm as long as they get 40 hours - 30 min lunch

Location: Rochester Hills MI

Pay Rate Range: 20/HR. We are paid WEEKLY

Benefits: Yes

"Pull claims, review them to see where they are at in the process, have they been paid, is there an error (missing modifiers, wrong name, prescriptions not attached) they will fix the basic errors and resubmit the claim to the payer. They will be required to pull claims, print claims, fax claims as necessary. They will be reaching out to the insurance companies to figure out what errors have occurred if it is not stated. They will not be talking to patients or doing collections from patients, all efforts will be geared towards the payers."

To be successful in this role a candidates must be able to understand tha basics of EOB's (explanation of benefits) and be familiar with medical claims to be able to recognize what is missing.

Essential Duties and Responsibilities:

• Process daily tasks assigned from the billing software system.

• Enter and process data related to patient care and reimbursement.

• Check to ensure all patient documents are on file and completed correctly.

• Connect with insurance payors by telephone or online regarding non-payment or short payment on outstanding claims. Respond to insurance payor correspondence.

• Review and resubmit simple corrections to low dollar claims to payors for reprocessing.

• Work AR aging reports for payors.

• Review claims forms to primary, secondary, and tertiary insurance payors as needed.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.