MD EyeCare Services Corporate

  • Claims Processing / AR Follow-Up Supervisor

    Job Locations US-CO-Denver
    Posted Date 3 weeks ago(10/24/2018 4:34 PM)
    Job ID
    2018-2795
    # of Openings
    1
    Category
    EyeCare Services Partners
    Type
    Regular Full-Time
  • Overview

    ESP Logo

    Eyecare Services Partners is a nationally recognized leader in Ophthalmic and Optometric care with dynamic leadership, excellent clinical support teams and an unwavering commitment to customer service and patient care.  We strive to make every interaction extraordinary, inspiring the complete confidence of our patients, partners and employees.  Our employees contribute directly to the success of our practices and take pride in being a member the ESP Management team. We strongly believe that the manner in which our patients, customers and employees is as important as the quality of the services we provide.

     

    The Claims Processing / AR Follow-Up Supervisor is responsible for the day to day tactical supervision of a group of individuals performing either Claims Processing or AR Follow Up for a region of ophthalmic and optometric practices.

    Responsibilities

    • Supervision of the processing of medical and/or vision claims generated within the practice management software system daily.
    • Supervision of the AR follow-up process with insurance payors to correct denied claims including
      • Submission of appeal letters, correct claims in accordance with Correct Coding Initiatives (CCI) and all Compliance regulations
      • Work with the clinics to gather information needed to correct and reprocess the claims
      • Training to avoid potential denials in the future.

    As an Individual Contributor:

    • Create claim batches and process all insurance claims daily
    • Understanding of claim edits and know the appropriate actions to take to correct the claim prior to submission
    • Prepare claim resubmissions, appeals and reviews
    • Research correct ICD and CPT codes to get claims paid for any rejections
    • Contact patient when necessary to obtain correct information to get the claim paid
    • Call insurance company when necessary to find out why claim is rejecting, and follow through by correcting information and resubmitting the claim for payment
    • Work with clinics to gather additional information that may be needed to correct a claim for submission to payor
    • Contact patient when necessary to obtain correct information to get the claim billed
    • Meet timely deadlines specified by management when billing charges
    • Maintain organized filing system for uploaded batches
    • Support and backup other areas of the department as needed

    Qualifications

    • 5 years of RCM, Medical Collections, Claims Processing, or AR experience is required
    • 2 years of experience in a supervisory capacity is required
    • High school diploma is required
    • Undergraduate Degree preferred
    • Experience in Ophthalmology and NextGen is preferred

    In turn we will offer:

    • Benefits to full time team members that include comprehensive medical, dental and optical coverage, 401K and short and long term disability
    • Company paid life insurance
    • Paid holidays and generous paid time off
    • Paid parking where applicable
    • Team oriented working environment where you are heard and respected
    • Clear career ladder opportunities

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