Claims Processor II

Job Description Summary Entity MUSC Community Physicians (MCP) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC004513 MCP - Revenue Cycle Pay Rate Type Hourly Pay Grade Health-21 Scheduled Weekly Hours 40 Work Shift Job Description Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies. Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve Follow up on denied or no response claims by calling third party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve. Keep management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level when necessary. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends. Maintains 95% quality standards on account follow and activity. Maintains productivity standard as set forth by management team. Will serve as preceptor for Physician Patient Accounting and receive STAR certification. Ability to cross-cover on any team as directed by management team or Director of Physician Patient Accounting. Provide payer feedback during team meetings encourage collaboration among groups. Collaborates with other claims processor II, to review and enhance existing workflows supporting training PPA team members. Other duties as assigned. Additional Job Description · Able to prioritize work on a daily basis. Requires independent judgement in handling patient accounts. Direct supervision availa