Claims Specialist

Rotech Healthcare Inc Orlando , FL 32801

Posted 7 months ago

OVERVIEW

Join the Leader in the Home Healthcare Industry! Let us be Your Road to Success

Rotech is seeking a Claims Specialist to join the Rotech team. In this position you will be responsible for analyzing, researching and instructing all Billing Centers appropriate resolution of electronic claim edits ensuring submission of electronic claims to payers. Ensures electronic remittance advices are routed to the appropriate Billing Center by analyzing and modifying routing logic with clearing house vendor.

Why work for Rotech? If we take a look at all the ways employees benefit from working at Rotech, we have a philosophy we like to call: "The Rotech Difference."

What's the Rotech Difference? It's made up of all the benefits, services and offerings available to Rotech Employees. It is the employee-based strategies that make our company an employer of choice in the healthcare industry. As a member of the Rotech Healthcare Team, employees can take advantage of many great opportunities as part of their career path.

JOB INFORMATION

Essential Duties and Responsibilities:

  • Collaborates with Rotech's clearing house vendor to determine the validity of claim edits and determine if system programming is needed to resolve the edit

  • Researches and trouble shoots application errors, transmission errors and/or payer clearing house errors and identifies possible resolution by reviewing claim edits by analyzing 835 files, payer companion guides, clearing house edit rules and payer claim submission guidelines and IMBS data to identify needed elements for complete transmission of claims

  • Conduct conference calls, leading in troubleshooting a problem resolution on individual and global level

  • Instructs Billing Centers on appropriate process for resolution of claim edits

  • Maintains and distributes Claim Edit Resolution Guide for training and education

  • Performs maintenance to various claims master tables ensuring accurate data exists for claims logic

  • Researches contract set-up, item master and any other potential claim process change to proactively solve problems, provide timely resolution and ensure minimal financial impact to Rotech's claims. Identifies the most appropriate course of action for problem resolution and effectively communicates plans to those impacted

  • Resolves identified claims issues in a timely fashion to mitigate financial risk in Rotech's claims processing cycle

  • Identifies payers that can transmit electronically and works with payers, Billing Centers and clearing house vendor to maximize electronic claims submission

QUALIFICATIONS

  • Minimum of one year directly-related experience in the medical billing industry

  • Two year degree, or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts

Physical Demands:

  • Walk, sit, talk, and listen for extended periods of time

  • Regularly review documents with small print

  • Utilize computer for long periods of time

Rotech offers:

  • Competitive Compensation

  • Career Path and Management opportunities

  • Health and wellness benefits to include medical, prescription, dental and vision plans, short term and long term disability, supplemental life insurance and flexible spending accounts

  • Employee Assistance program

  • PTO and paid holidays

  • 401K

  • Bonus'

  • Employee Discounts

  • Employee Referral program

  • Employee Recognition program

  • Employee Service Program

Make the right move, Contact us today!

This application process will take approximately 2-5 minutes to complete. The hiring manager will review your resume and contact you if your qualifications match our needs. We appreciate your interest in Rotech Healthcare Inc.

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities

Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy, gender identity or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.


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Claims Specialist

Rotech Healthcare Inc