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Reimbursement Call Center Customer Service Counselors

Company:
Kelly Services, Inc.
Location:
Rockville, Maryland, United States
Salary:
18 per hour
Posted:
November 07, 2016
Description:

Our client in Rockville, Maryland, is looking to hire 32 contract Reimbursement Call Center Customer Service Counselors for 3 months. The role could be extended up to 6 months and some of the positions could go permanent. The start date for the training class is November 1, 2016.

Rockville, MD 20850

Payrate: $18 per hour

Candidates must be flexible to work any of these shifts: 9:00am-6:00pm, 10:00am-7:00pm and 11:00am-8:00pm. Training will be 9:00am-6:00pm for the first 6 weeks of the assignment.

Please Note: Nearest Metro stop is Shady Grove off the Red Line and you would need to take the 66 bus route to get to the client site.

Benefits while temporary include: A Kelly Service Representative who is dedicated and assigned specifically to your client site to help you network for additional opportunities; Medical/Dental/Vision coverage options through Kelly Services; Weekly compensation (paycheck)

This role will involve a combination of taking inbound calls, making outbound calls and document review

Responsible for various reimbursement functions, including but not limited to:

- Accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.

- Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.

- Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.

- Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.

- Researches and resolves any electronic claim denials.

- Researches and resolves any claim denials or underpayment of claims. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.

- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

- Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.

- Reports any reimbursement trends/delays to supervisor e.g. billing denials, claim denials, pricing errors, payments, etc.

- Processes any necessary insurance/patient correspondence.

- Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification NPI number, and referring physicians.

- Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.

- Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

- Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims.

- Works on problems of moderate scope where analysis of data requires a review of a variety of factors.

- Exercises judgment within defined standard operating procedures to determine appropriate action. Typically receives little instruction on day-to-day work, general instructions on new assignments. Performs related duties as assigned.

Must-Have Requirements:

High School Diploma or G.E.D. equivalent with documentation

Call Center and Healthcare experience of at least a year

Experience working in a Customer Relationship Management Database (CRM) such as Salesforce or a company-specific program

Preferred Requirements:

Lash experience

Candidates should also have:

Strong organizational skills; attention to detail.

General knowledge of accounting principles, pharmacy operations, and medical claims.

General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred.

Global understanding of commercial and government payers preferred.

Ability to proficiently use Microsoft Excel, Outlook and Word.

Professional expertise; applies company policies and procedures to resolve a variety of issues.

Ability to communicate effectively both orally and in writing.

Ability to build productive internal/external working relationships.

Strong interpersonal skills. Strong negotiating skills. Strong mathematical skills.