Select Medical

Inpatient and outpatient rehabilitation services network

Medicare Claims Resolution Specialist

Claims AdjudicationPosted on Nov 5

Full-timeCamp Hill, PA, USA$17.50 /hr

About the Job

Requirements

A high school diploma or equivalent is required.
One year of experience in a medical billing, medical collecting, or claims processing role is required.
Private and commercial claims collection experience is required, ideally on the provider side.
Knowledge of Medicare and Medicaid is required.
Computer skills are preferred.
Microsoft Office skills, including Outlook and Excel, are preferred.
Ability to work with multiple programs simultaneously is preferred.
Good interpersonal, oral, and written communication skills are preferred.
Previous experience in a metrics-based role with production and quality standards is preferred.
Time-management and organizational skills are preferred.
Investigative research experience is preferred.
Ability to work independently and as part of a team to reach mutually established goals is preferred.
Attention to detail is preferred.
Flexibility and openness to change are preferred.
Ongoing discretion and secure information management are required when accessing confidential and sensitive information.
Ability to sit for extended periods and lift up to 35 pounds is required.

Responsibilities

Investigate and follow up on open account balances that have received a payment or denial, or are more than 30 days from billing; contact the responsible party to establish the reason for non-payment, document verbal and written communications in the system, and follow up promptly to support resolution and payment.
Maintain consistent, productive, and timely account follow-up as often as needed, with no more than 30 days between follow-ups.
Maintain productivity of 20 to 25 accounts per day, subject to volume changes and operational needs.
Make outgoing calls to patients, insurance companies, and attorneys regarding claim status to reduce outstanding receivables.
Communicate regularly with hospital staff and department management about accounts-receivable issues and problematic payer trends.
Identify and resolve issues affecting timely collection of open receivables.
Request account adjustments through write-off and refund requests as needed.
Notify database operations of changes or additions to payer, plan, contract, address, or other relevant information as needed.
Meet productivity and collections targets set by management.
Perform other assigned duties or special projects.

Desired Qualifications

Computer skills.
Microsoft Office skills, including Outlook and Excel.
Ability to work with multiple programs simultaneously.
Good interpersonal, oral, and written communication skills.
Previous experience in a metrics-based role with production and quality standards.
Time-management and organizational skills.
Investigative research experience.
Ability to work independently and as part of a team to reach mutually established goals.
Attention to detail.
Flexibility and openness to change.

Overview

Medicare Claims Resolution Specialist

(on-site)

Starting at $17.50/hr, but flexible for experienced candidates

Do you enjoy puzzles and research? Are you results-oriented? If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select Medical! Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted.

We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities. Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen minute breaks and one half-hour lunch. We allow for casual work attire, jeans are our norm!

Responsibilities

Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing. Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
Regularly communicate with hospital staff and department management on any accounts receivable issues/problematic payor trends.
Identify and resolve issues impacting the timely collection of open receivables.
As necessary, request account adjustments as identified via write off requests and refund requests.
Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
Meet the expectations and goals for productivity and collections targets as set forth by management.
Performs other duties or special projects as assigned.

Qualifications

Required:

High School Diploma or Equivalent
One year of experience within a medical billing, medical collecting or claims processing role.
Private and commercial claims collection experience (ideally provider side)
Medicare and Medicaid

Preferred:

Computer Skills
Microsoft Office:
Outlook
Excel
Ability to work with multiple programs simultaneously.
Good interpersonal, oral and written communication skills.
Previous experience in metrics based role, where production/quality standards are upheld.
Time management and organizational skills
Proven experience with investigative research.
Ability to work independently and as part of team to reach mutually established goals.
Attention to detail
Flexibility and being open to change
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Additional Data

Select Medical strives to provide our employees with a solid work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors.

An extensive and thorough paid orientation program.
Paid Time Off (PTO) and Extended Illness Days (EID).
Health, Dental, and Vision Insurance; Life insurance; Prescription coverage.
A 401(k) retirement plan with company match.
No Required Weekends

Working Conditions/Physical Demands:

Office Environment
Sitting for extended periods of time
Ability to lift weight up to 35 lbs.

Equal Opportunity Employer/including Disabled/Veterans

Compensation: 17.5 to N/A (USD)

About the Company

Select Medical

Inpatient and outpatient rehabilitation services network

Select Medical operates a network of hospitals and rehabilitation centers across the United States, providing critical illness recovery, inpatient rehabilitation, and outpatient rehabilitation. It coordinates patient care from acute treatment through recovery using both inpatient and outpatient programs, with revenues from patient services, insurance reimbursements, and healthcare partnerships. The organization distinguishes itself with a focused rehabilitation specialty, a large nationwide footprint, and a commitment to employee development and work-life balance to maintain high-quality care. Its goal is to help patients regain independence and return to daily life through effective, patient-centered rehabilitation and recovery services.

Company size: 10,001+
Company stage: IPO
Headquarters: Mechanicsburg, PA
Founded: 1996

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