Medical Assistant - DRG Claims (Remote)

Job Title: Full Remote Medical Assistant - DRG ClaimsThis is a temp-to-permanent position (full remote)Pay: $35-$38/hr

Job Description:

We are seeking a skilled and experienced Medical Assistant with a focus on DRG Claims to join our team in a full remote capacity. Reporting to the Medical Claims Review Nurse, this position encompasses a range of responsibilities including appeals, claims analytics, DRG Validation claims repricing, and outpatient payment integrity audits. The ideal candidate will have a comprehensive understanding of medical assistant duties and protocols alongside proficiency in claims processing and regulatory compliance.

Key Responsibilities:

• Perform all back-office functions of a medical assistant within the MA scope of practice, including patient intake, health history recording, preparation for exams or procedures, immunizations, medication administration, vital signs monitoring, venipuncture, and injections.
• Provide guidance to staff and feedback to management on audit concept performance.
• Ensure compliance with State and Federal Regulatory programs and documentation requirements for claim payment.
• Maintain accurate patient visit documentation, including logs, charting, and inventory management.
• Review and process non-clinical appeals for overpaid claims.
• Conduct repricing of identified claims to identify overpayment variances for DRG Validation claims.
• Perform outpatient payment integrity audits.

Must-Have Skills:

• Proficiency in medical terminology.
• Strong interpersonal and problem-solving skills.
• Excellent English communication skills (speaking, reading, writing, understanding).
• Computer proficiency, including typing and database support.
• Familiarity with Electronic Medical Record (EMR) and Practice Management (PM) systems.
• Ability to follow direction and adhere to established policies and procedures.
• Reliable attendance based on agreed-upon schedule.
• Commitment to maintaining confidentiality and compliance with HIPAA and PHI regulations.
• Ability to establish and maintain positive work relationships with colleagues, clients, providers, and customers.

Requirements:

• 5+ years of experience as a Medical Assistant.
• High School Diploma or GED equivalent.
• Graduate from a federally accredited, state-licensed vocational/technical school medical assistant program.

If you meet these qualifications and are looking for a challenging and rewarding remote opportunity in the healthcare field, we encourage you to apply. Join us in making a difference in healthcare delivery through accurate claims processing and integrity auditing.