Claims Integrity Specialist

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Claims Auditor

Job Title: Claims Integrity Specialist

Company Overview: Our client is a leading provider of superficial radiation therapy services nationwide. Partnering with over 200 practices across the United States and generating revenue exceeding $70 million, our company is rapidly expanding, offering excellent opportunities for career growth.

Job Description: We are currently hiring a full-time Claims Integrity Specialist to join our dynamic team.

The Claims Integrity Specialist will be responsible for managing day-to-day operations related to accounts receivable (A/R) and responding to inquiries from insurance companies. This position requires in-depth knowledge of medical terminology, ICD-10 and CPT coding, as well as familiarity with major insurance carriers, insurance verification, benefits, and referrals. The successful candidate will excel in researching claim denials and submitting appeals promptly. Additionally, a thorough understanding of HIPAA compliance rules and regulations is crucial for this role.

Responsibilities:

  • Oversee day-to-day operations of accounts receivable (A/R).
  • Handle inquiries from insurance companies via written communication and phone conversations, as required.
  • Investigate claim denials and prepare and submit appeals.
  • Ensure accurate and timely medical coding using ICD-10 and CPT coding systems.
  • Stay updated on major insurance carriers, insurance verification procedures, benefits, and referrals.
  • Follow HIPAA compliance rules and regulations meticulously.
  • Maintain effective and courteous communication with colleagues and external parties.
  • Collaborate efficiently with team members, showcasing problem-solving abilities and sound judgment.

Requirements:

  • 2 to 3 years of medical coding experience.
  • Preferred: Certified Dermatology coder/biller.
  • Proficiency in medical terminology, ICD-10, and CPT coding.
  • Familiarity with major insurance carriers and insurance verification processes.
  • Thorough understanding of HIPAA compliance rules and regulations.
  • Excellent written and verbal communication skills.
  • Ability to collaborate effectively with others and display strong problem-solving skills.

Benefits: Joining our team means becoming part of a vibrant and highly motivated group of individuals dedicated to achieving success.

As a member of our team, you will have the opportunity to work with diverse individuals, making each workday enjoyable and exciting.

We offer a competitive salary and an exceptional benefits package, including comprehensive medical, dental, vision, life, and disability insurance, a generous PTO (Paid Time Off) plan, and a matching 401K. This is a hybrid position, allowing you to work from home two days a week.

Work Environment: Our Burr Ridge office fosters a relaxed and enjoyable atmosphere with a casual dress code.

Salary: Salary will be determined based on experience.

If you are a highly motivated and skilled Claims Integrity Specialist with a passion for the healthcare industry, we encourage you to apply and become a valuable member of our dynamic team.

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