Medical Claims Technician I

SUMMARY

Researches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Researches denial of claims, evaluates and rebills as necessary in an effort to ensure the maximum accurate payment and reduce the number of A/R days

• Communicates with Business Office or clinical staff regarding coverage and denials, if appropriate

• Sustains aged A/R of less than 120 days

• Maintains a high level of integrity and commitment to accurate claims processing

• Performs other duties as assigned

QUALIFICATIONS

• One year of experience with insurance billing and claims research preferred

• High school or equivalent with emphasis on business related courses

• Ten key, computer/data entry, spreadsheets, and word processing

• Communication, analytical and problem solving skills

• Ability to multi-task and meet deadlines

• Detail oriented and organizational skills

• Excellent verbal and written communication skills

• Ability to work independently and collaboratively within a team environment

• Commitment to the mission of Red Rock BHS

BENEFITS (Full-Time Staff Only)

• 95% Employer Paid Health Insurance Plan

• Dental Insurance

• Vision Insurance

• Some Positions Qualify for NHSC Student Loan Repayment

• 403B Retirement Plan with 5% Employer Contribution

• Annual Professional Growth Funds

• 3 Weeks Paid Time-off

• Employer Paid Life Insurance and Long Term Disability

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

Red Rock Behavioral Health Services does not discriminate based on race, color, national origin, religion, gender, gender identity, age, marital/familial status, sexual orientation, or disability.