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Claims Specialist

*ETHOS LABORATORIES* – Newport, KY

LOCATION: This position is located in Newport, KY, two blocks from Newport on the Levee.

HOURS: Monday – Friday, 7:30AM – 3:30PM

EDUCATION AND EXPERIENCE REQUIREMENTS:

  • High school diploma or GED required
  • 5 or more years of medical billing experience preferred
  • Laboratory and/or workers compensation experience a plus
  • Billing or Coding Certification a plus

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Submits claims on a daily basis and assures claim files reach clearinghouse
  • Verifies and reviews charges are submitted on a daily basis to payers for adjudication
  • Processes all specialized billing for the lab
  • Reviews and resolves clearinghouse rejections in a timely manner
  • Reviews and resolves billing system rejections in a timely manner
  • Reviews and resolves paper rejections in a timely manner
  • Assists with department phone calls
  • Updates patient registration and insurance information as needed
  • Contact patients to obtain insurance and demographic information
  • Establishes a working relationship with payers, clients, and internal staff
  • Assist billing staff including but not limited to Appeals, Follow-up, Payment posting, ecommerce etc.
  • Must maintain active certification, if applicable
  • Other duties/projects as assigned by management

CORE COMPETENCIES AND QUALIFICATIONS:

  • Regular and prompt attendance
  • Exceptional accuracy and attention to detail
  • Effective verbal and written communication
  • Excellent phone etiquette
  • Good knowledge of all aspects of the Revenue Cycle
  • Ability and experience with Microsoft Outlook, Word, and Excel
  • Ability to work well in a team environment
  • Follow all department and company policies and procedures