Claims Resolution Specialist

Job Description

Job Description

JOB OVERVIEW

Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while maintaining appropriate documentation and account records, as well as timely issue resolution. In this role, you will ensure work is in compliance with all legal, regulatory, and internal Integra policies and procedures, including HIPAA compliance. If you have previous medical billing or claims experience, this role may be of interest as a next step in your career.

JOB RESPONSIBILITIES

• Accountable for daily productivity goals at or above the current production metric
• Maintain a climate of teamwork and collaborative problem solving
• Uses problem solving skills and planning abilities to diagnose and solve root process, payer and communicate system issues impacting revenue cycle objectives
• Stay informed on product information, changes in Medicare / State / Contract funding procedures, and updates in policies and procedures
• Contribute beyond fundamental responsibilities to support company growth and department development
• Adds value and positive contributions towards the company and department culture
• Understand and perform duties in compliance with State and Federal regulations and the policies and procedures of Integra
• Achieve and maintain an individual effectiveness rate of 70% +
• Contributes to the department maintaining AR aging over 120 days at 10% or less of total inventory
• Strong Microsoft Office skills (Excel in particular) and ability to learn new programs and software
• Must type 45+ words per minute
• Familiar with ICD-10, HCPCS, and medical terminology
• Ability to follow verbal and written instructions
• Ability to maintain consistent, regular attendance and punctuality
• Performs miscellaneous duties as assigned

WHAT WILL YOU LEARN IN THE FIRST 6 MONTHS?

WHAT WILL YOU ACHIEVE IN THE FIRST 12 MONTHS?

COMPENSATION : $19.00 / hour

EXPERIENCE :

Benefits Offered

Remote Opportunities

We are actively seeking new colleagues in : Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, and Washington.

Our Story

Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health.

With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values : One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.

Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Powered by JazzHR

z80ckBVIGH