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Claims Specialist in Orlando at Vaco

Date Posted: 2/5/2019

Job Snapshot

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  • Experience:
    At least 2 year(s)
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Job Description

Claims Specialists, let Vaco advocate for you and you'll have an advantage over your competition! Our recruiters have direct relationships with hiring managers, so they can connect your work experience to the open job. Our client has an immediate opportunity for an Claims Specialist. Instead of being another faceless resume, let Vaco promote your strengths to the hiring manager while preparing you for that specific interview.

Our recruiters will provide you with great insight about trends in the market-keeping you up to date on compensation expectations, company culture and growth opportunities. If you're an experienced Claims Specialist and you want to partner with the best, apply today!

As an Claims Specialist, you will analyze financial information and prepare financial reports to determine or maintain record of assets, liabilities, profit and loss, tax liability, or other financial activities for our client.

Claims Specialist responsibilities:

  • Collaborates with Rotech's clearing house vendor to determine the validity of claim edits and determine if system programming is needed to resolve the edit
  • Researches and trouble shoots application errors, transmission errors and/or payer clearing house errors and identifies possible resolution by reviewing claim edits by analyzing 835 files, payer companion guides, clearing house edit rules and payer claim submission guidelines and IMBS data to identify needed elements for complete transmission of claims
  • Conduct conference calls, leading in troubleshooting a problem resolution on individual and global level
  • Instructs Billing Centers on appropriate process for resolution of claim edits
  • Maintains and distributes Claim Edit Resolution Guide for training and education
  • Performs maintenance to various claims master tables ensuring accurate data exists for claims logic
  • Researches contract set-up, item master and any other potential claim process change to proactively solve problems, provide timely resolution and ensure minimal financial impact to Rotech's claims. Identifies the most appropriate course of action for problem resolution and effectively communicates plans to those impacted
  • Resolves identified claims issues in a timely fashion to mitigate financial risk in Rotech's claims processing cycle
  • Identifies payers that can transmit electronically and works with payers, Billing Centers and clearing house vendor to maximize electronic claims submission
  • Minimum of one year directly-related experience in the medical billing industry
  • Two year degree, or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts