Claim Scrubber ( Claim Representative )

Description

SUMMARY: SightMD’s vision is to be the greatest eye care company the world has ever seen. Our mission is to provide an unparalleled care experience for patients with 7-days-a-week access to world-class quality eye care in the convenience of their local neighborhoods, delivered by a dedicated, caring, and talented healthcare team.

SightMD is looking for career minded individuals to be at the heart of that vision and assist in the daily patient care and flow of clinic activities. As a Payment poster you will be responsible to process, verify, balance, and adjust billing and accounts payable transactions requiring the use of independent judgment. Your schedule will vary, dependent on the operational hours of the office you are assigned to. You must have the flexibility to work within these hours of operation, including occasional weekends, early mornings, or late evenings as needed.

Starting Salary Rate $ 18.00/ Hour + based on experience

Job Duties & Essential Functions

• Consistently achieves weekly coding output within the minimal productivity standards. Self-manages and prioritizes workflow to achieve timely submission of claims and optimal productivity.
• Maintains a 95% ongoing accuracy rate based on Medical Record Department performance monitors and third-party validation audits.
• Other specials projects set by the Revenue Cycle Manager.
• Demonstrates complete understanding of coding rules.
• Remains abreast of developments in health information management by pursuing a program of professional development, attending educational programs and meetings, and reviewing pertinent literature.
• Reviews all medical record documentation to determine and assign diagnoses, procedures, level codes and modifiers, to ensure appropriate coding for case mix.
• Analyzes, sequences, and validates assigned codes based on medical record documentation using coding compliance resources.
• Scrubs and Post charges for PC entities
• Assists in the orientation and development of new coding personnel.
• Assumes professional responsibility for development of skills and ongoing education to maintain certification.

Required Qualifications

• 1
• Great communication and organization skills.
• Knowledge of medical terminology is required.
• Basic excel skills such as the ability to perform or simple calculations with formulas and functions and format spreadsheets is required.
• Years of medical billing experience is required.
• Bilingual in English and Spanish or ability to speak other languages is desirable.
• High School Diploma or equivalent required, degree from an accredited college or medical business school is preferred.

Qualifications

Education

Required

• High School or better