Claims processor Jobs in Charleston, SC

Job Description
Summary

The Credit Processor diligently follows the workflows established to properly research, analyze and resolve undistributed and credit transactions within the EPIC system. Process all levels of transactions needed for resolution (transfers, posting, offsets, refunds, etc.). Will use available resources: Workflows, Email, Excel, Word, Fee Schedules etc. to verify insurance, patient, and guarantor information. Review websites, contact insurance carriers and/or guarantors and update demographics, coverage and/or claim information accordingly. Note accounts with actions taken. The ability to be accountable, adaptable and flexible to changes to processes, assigned tasks and meet set deadlines.

Entity

MUSC Community Physicians (MCP)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC004513 MCP - Revenue Cycle

Pay Rate Type

Hourly

Pay Grade

Health-21

Scheduled Weekly Hours

40

Work Shift

Job Description

Entity/Organization: MUSC Physicians (MUSCP)

Hours per week: 40

Scheduled Work Hours/Shift: Monday - Friday 8:00am - 5:00pm

Pay Basis/FLSA: Hourly/Non-Exempt

Remote Option: This position offers a remote work schedule

Required Minimum Training and Education: High school diploma and one-year revenue cycle work experience required. Prior account analysis, credit resolution, billing and/or insurance follow up experience in a hospital or physician office setting preferred with working knowledge of insurance payor remittances, and Epic system knowledge helpful. Must have excellent organizational, analytical, and communication skills. Desired candidates are dependable; team focused, goal-oriented individuals with a strong work ethic and positive attitude.

Degree of Supervision: Must be able to work independently under the direction of the Department Supervisor and Manager.

Required Licensure, Certifications, Registrations: N/A

Job Duties and Responsibilities:

• Undistributed/Overposted (credit) transactions. Process undistributed and credit transactions through assigned work queues or reports according to department’s workflows. Process all levels of transactions needed for resolution (transfers, posting, offsets, refunds, etc). Use available resources: Workflows, Email, Excel, Word, Fee Schedules etc. Verify insurance, patient, and guarantor information. Review websites, contact insurance carriers and/or guarantors and update demographics, coverage and/or claim information accordingly. Note accounts with actions taken.
• Completed Contribution Average. Maintain department’s current Completed Account Contribution totals daily, weekly, monthly. (Productivity)
• Audits. Maintain >=97% accuracy rate on audit reviews.
• HPF Insurance Refund Request Letters WQs. Review and process weekly to ensure resolution is met prior to deadlines stated in the request letters and/or set workflows and regulations.
• Returned Refunds-Credit Processors will review; verify information pertaining to the reason of the return and/or consult with other departments when their refunds are returned for resolution. Process the cancelations to repost, reissue, and apply to escheatment or MISC Income for resolution.

Physical Requirements: Continuous requirements are to perform job functions while standing, walking and sitting. Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions. Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors. Frequently lift and/or carry objects weighing 20 lbs (+/-) unassisted. Lift from 36” to overhead 15 lbs. Infrequently work in dusty areas and confined/cramped spaces.

Additional
Job Description

High school diploma and one-year revenue cycle work experience required. Prior account analysis, credit resolution, billing and/or insurance follow up experience in a hospital or physician office setting preferred with working knowledge of insurance payor remittances, and Epic system knowledge helpful. Must have excellent organizational, analytical, and communication skills. Desired candidates are dependable; team focused, goal-oriented individuals with a strong work ethic and positive attitude.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees