Claims and Billing Specialist (L2) Part-Time 32 Hours a Week in Silver Spring, Maryland at Primary Care Coalition of Md
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Job Description
Hourly Rate Range: $25.00-$27.00 Per Hour
Employee Benefits: Medical, Dental, Vision all with Carefirst Blue Cross Blue Shield, Prorated Paid Time Off (Annual, Sick, Personal, Holidays), 403B Plan, Short-Term & Long Term Disability, Life Insurance.
Telework: This position is approved for telework when activities do not require a physical presence. This role is expected to be onsite at PCC headquarters for in-person meetings two-to-three times per month. More frequent time onsite may be required depending on program needs. It is an expectation to regularly attend in-person meetings and enable video capabilities when meeting with external clients and/or communicating with patients via MS Teams. Note: PCC employees must reside in the following five states or District of Columbia: MD. VA, WVA, DE. PA, DC. Relocation expenses are not reimbursed.
The Claims and Billing specialist will be responsible for coordinating and completing the entire claims adjudication process for programs within their portfolio. Responsibilities include verifying payment eligibility of invoices and claims, entering eligible patient demographics and encounter data into the billing system with accurate data and documentation. Issuing provider payment letters and collaborating with the finance department on payment requisitions for approved claims. Updating provider contact lists and fee schedules, reviewing contracts to ensure correct payments. Addressing complex claims issues, escalating when necessary. Additionally, this role will support annual contract renewal and credentialing processes for providers in their assigned portfolio.
Essential Duties
Educational Experience
- Bachelor’s Degree in Healthcare Administration or Business Administration, or other relevant certification or work experience. 1 to 3 years relevant work experience preferably in the nonprofit sector.
Skills and Abilities
ADA Requirements
This job operates in a professional office environment. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• This role routinely uses standard office equipment such as computers, telephones, photocopiers, filing cabinets and fax machines.
• This is largely a sedentary role; however, some filing may be required.
• This would require the ability to lift files, open filing cabinets and bend or stand as necessary.
• Requires ability to learn new software applications as necessary.
• Must be able to lift up to 20 pounds.
• Must be able to travel.
Disclaimer
This job description indicates in general the nature and levels of work, knowledge, skills, abilities and other essential functions (as covered under the Americans with Disabilities Act) expected of an incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of an incumbent. An incumbent may be asked to perform other duties as required.
Primary Care Coalition is an Equal Opportunity Employer