Medical Claims Specialist with prior Credentialing experience a must
Company: DYNIX DIAGNOSTIX LLC
Location: Fort Pierce
Posted on: January 22, 2023
Job Description:
Please do not apply if you do not have prior credentialing,
claims and billing experience, thank you.******* Only local
candidates with prior experience in BILLING, CLAIMS AND
CREDENTIALING need apply*****MUST HAVE PRIOR EXPERIENCE
Dynix Diagnostix, founded in 2016, is an industry leading,
full-service clinical laboratory. We deliver quality service and
efficient results for molecular genetics, blood testing and
toxicology.At -Dynix Diagnostix -our greatest asset is our people.
We offer a friendly environment, competitive wages and a benefits
package. We are in growth mode and need to add people to our
already dynamic team. If you are interested in joining the best
Laboratory on the Treasure Coast, please submit your
resume.POSITION SUMMARY: - -This position will be working with
Medical Billing/Collections AND Credentialing- - -******* Only
local candidates with prior experience in billing, claims and
credentialing need apply*****The Medical Billing and Collection
Specialist -is responsible for ensuring accurate billing, timely
submission of electronic and/or paper claims, monitoring claim
status, researching rejections and denials, documenting related
account activities, posting adjustments and collections for
Insurance, Contract and Private Pay.
- Major Duties and Responsibilities:
- -In addition to the major duties and responsibilities listed
above, this position will be responsible for special projects and
assignments on an as needed basis.
- Complete required trainings, and additional recommended
trainings that can help promote compliance with a variety of
employment obligations.
- -Perform other duties as assigned by department manager.
- -Prepare, store and retrieve patient health records (commercial
and governmental payers).
- Bill (1500 form) to both commercial and governmental
payers.
- -Identify billing issues and determine the source of the
problem to ensure it does not occur in the future.
- Responsible for working denials from insurances daily.
- -Verify patient insurance coverage; attain required referrals
or authorizations when needed.
- Understand and participate in all aspects of the billing &
collection processes.
- SKILLS AND ABILITIES:
- Ability to lift 40 pounds.
- Maintains good attendance and punctuality.
- Actively explores new educational pursuits to improve job
knowledge and skills
- Accepts ownership for all tasks and responsibilities.
- Excellent organization skills, verbal and communication
skills.
- Positive attitude and team player.
- -Strives to deliver high-quality results at all times in
accordance with standards.
- Proudly services the company by following all HIPAA, JCAHO,
state, and federal laws and standards.
- Maintains strict confidence of patient, client, company and
employee information.
- Other Criteria:
- -Prolonged periods of sitting at a desk and working on a
computer.
- Ability to multitask in a fast-paced environment and
willingness to adapt to change.
- Ability to prioritize, meet deadlines and maintain strong
working relationships with others, internally and externally.
- Ability to accurately process high volumes of work within a
short period of time.
- Needs to be familiar with ICD-10, CPT, and/or HCPCS Coding
Systems as well as claim form CMS-1500.
- Ability to apply policies and procedures; performs job safely
with respect to others, to property, and to individual safety and
works effectively with others.
- Ability to analyze, evaluate and report data without
oversight.
- -Ability to process high volumes of work, without errors.
Credentialing -This position is primarily responsible for
initiating and maintaining state and commercial payor credentialing
- all states where Dynix Diagnostix, LLC currently practices. This
individual will work closely with - enrollment and licensing to
effectively navigate a variety of complex state and/or federal
policies and requirements, which is critical to the operation of
our medical laboratory.
- Major Duties and Responsibilities:
- Initiate and maintain credentialing for all locations
- Communicate adverse, incomplete, or questionable data to
designees and recommend appropriate course of action.
- Initiate and maintain payor enrollment. - -
- Prepare initial credentialing and re-credentialing files to be
presented to the C.O.O in a timely and expeditious manner
- Initiate and maintain provider services payor enrollment as
assigned
- Ensure accuracy and completeness of provider services -
applications whether state or private
- Provide regular updates to the payors of changes in billable
provider demographics, practice locations, name changes, etc.
-
- Maintain accurate and concurrent updates for each location to
reflect the history of a organization's credentialing and
enrollment status
- Resolve complex issues relating to provider credentialing
- Respond to requests by external and internal entities regarding
issues pertaining to the status of credentialing and/or enrollment
of organization. -
- Prepare for re-credentialing applications on all services and
locations
- Other duties upon request
- KNOWLEDGE, SKILLS AND ABILITIES
- Comprehensive knowledge of medical, clinical, and payor (both
commercial and managed care) credentialing regulations and
process
- Strong organizational skills, detail-orientation with the
ability to prioritize
- Time management skills in a fast-paced environment
- Excellent Analytical skills to problem solving
- Strong communication both written and verbal
- Problem solving skills and ability to explore all options and
use available resources to find new and effective solutions
- Strong organizational, critical thinking and problem-solving
skills required
- Ability to communicate appropriately and effectively with
providers; including sensitive and confidential information
- Must be able to prioritize and meet deadlines on an ongoing
basis to ensure timely completion according to process
requirements
- Exhibits sound judgment and one who hold themselves up as a
role model and mentor Requirements:EDUCATION AND/OR TRAINING: High
School Diploma or GED. Associate degree desired.EXPERIENCE:*******
Only local candidates with prior experience in billing, claims and
credentialing need apply*****
Billing/Claims
- 1 year of Medical billing.
- Medicare Claims and Commercial Insurance Claims.
- Knowledge / familiarity with medical terminology.
- MicrosoftCredentialing
- 1 + year of years of technical training and 3+ years experience
preferably with commercial, Medicaid Managed Care, and other payor
credentialing.
Physical Demands and Work Environment: -Physical demands: -While
performing duties of job, incumbent is occasionally required to
stand for full shift; walk; sit; use hands to handle, or feel
objects, tools, or controls; reach with hands and arms; talk and
hear. Employee must occasionally lift and/or move up to 35 pounds.
-Work environment: -A/C work area, the noise level is usually
moderate.Additional Information:We are looking for dedicated people
who wants to grow with our company.Dynix Diagnostix does not accept
applications, inquiries or solicitations from unapproved staffing
agencies or vendors.Equal Opportunity Employer:
Minorities/Women/Protected Veterans/DisabledEEO is The Law
Keywords: DYNIX DIAGNOSTIX LLC, Fort Pierce , Medical Claims Specialist with prior Credentialing experience a must, Healthcare , Fort Pierce, Florida
Didn't find what you're looking for? Search again!
Loading more jobs...