Campus Pride Jobs

• Processes healthcare Medicaid medical claims through Emomed
• Coordinates EVV use with vendor
• Oversees medical billing team and the submission of claim reports and filing procedures.
• Prepares and submits clean claims to various insurance companies by a billing clearinghouse .
• Gathers insurance billing information by reviewing patient hospital records; checking for completeness.
• Bills carrier by inputting billing information to database; initiating electronic transmissions.
• Process claims as they are paid and credit accounts accordingly.
• Resolves disputed claims by gathering, verifying, and providing additional information; following-up on claims.
• Resolves discrepancies by examining and evaluating data; selecting corrective steps.
• Adjusts patient bills by reviewing remittance advice; consulting with payer.
• Monitor payer claim acceptance and response timeliness.
• Contact payers when needed to obtain claim payment updates.
• Correct and resubmit claim denials.
• Escalate claims for potentially payer relations bulk resolution.
• Ensure proper charge capture, billing, and adjudication of claims per federal, state, and private billing guidelines.
• Prepares monthly reports of billing by summarizing billings, adjustments, and revenues received.
• Updates job knowledge by participating in educational opportunities; reading professional publications; keeping current on billing and reimbursement procedures.
• Ensures billing operations are performed in an accurate and timely manner.
• Evaluates billing processes and procedures and assists management in developing revisions.
• Monitors the revenue cycle activities and resolves any issues.
• Qualifications:

```{=html}

``` - Proof of High School Diploma or GED - Minimum of 2 years of Healthcare medical claims processing or billing experience required (Emomed/Trizetto/Gateway EDI) - Ability to effectively manage workload in a high-volume environment, strong attention to detail - Working knowledge of PC applications (Microsoft Office Suite)- Strong Excel Experience is required) - Ability to compute percentages and basic math functions - Effective oral, written, and interpersonal communication skills