AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. The company’s mission is to modernize and digitize the delivery of healthcare and improve lives by simplifying healthcare and reducing the cost of care.
This role is responsible for gathering and processing the information required to complete the medical insurance claims process. The position documents and enters required information into internal systems, manages outstanding accounts with insurance carriers, monitors claim submission, prepares appeal letters, reviews supporting documentation, and helps resolve claim submission errors and payer-specific issues.
Essential functions
- Monitor delinquent accounts and help resolve issues to obtain payment
- Compile appeal letters with LCD/NCD and payer requirement citations
- Track HCPCS codes and payer policy changes
- Interpret and apply medical policies and procedures
- Maintain access credentials for assigned payer portals
- Work assigned tasks in the practice management system to maintain productivity metrics
- Respond to correspondence from clients and the RCM team in a timely manner
- Work zero pays, underpayments, denials, and other claim issues
- Prevent timely follow-up denials on claims or appeals
- Determine covered medical insurance losses and overpayments
- Document claim actions and resolutions according to SOP
- Analyze insurance claims to help prevent fraud
- Maintain professionalism, confidentiality, and discretion
- Follow HIPAA rules and regulations
Work location
This is a hybrid/remote position with travel required as needed. The candidate must reside within 30 miles of the office in South Bend, Indiana.
Qualifications
- Claims experience in a hospital or inpatient setting required
- High school diploma or GED required
- Medical office experience and medical terminology preferred
- Detail-oriented with strong problem-solving skills
- Proficiency in Microsoft Office preferred
- Working knowledge of electronic medical records or other medical software preferred
- Strong communication and organizational skills
- Ability to work in a fast-paced environment and prioritize tasks
- Ability to work with patients and family members in a confident, respectful, professional manner
- Must be able to rely on experience and judgment to plan and accomplish goals
Benefits
- Medical, dental, and vision insurance
- Employer-paid life insurance
- Long-term and short-term disability coverage
- Above-average paid time off for new hires
- Comprehensive wellness program
- Onsite biometrics and ongoing mental and physical wellness support
- Access to financial wellness counselors
- Employee assistance services
- Company-matched 401(k) plan
Location
Indiana, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago