PPO Claims Processor – BroadPath

Welcome to the Latest Job Vacancies Site 2024 and at this time we would like to inform you of the Latest Job Vacancies from the BroadPath with the position of PPO Claims Processor – BroadPath which was opened this.

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Our culture is based on connection and that fuels our outstanding performance At BroadPath we maintain and nourish a commitment to home-based talent and

About Us:

Our culture is based on connection, and that fuels our outstanding performance. At BroadPath, we maintain and nourish a commitment to home-based talent and innovative workforce technology that enables us to deliver unrivaled quality, flexibility, and transparency. We believe in meeting our associates where they are, be it in geography or career development. Our proprietary platform visually connects the members of each home-based client team, fully unleashing the skills and motivation of the industry’s best workforce and enabling our associates to reach their full potential. BroadPath is where connection happens.

Today, we provide services to Fortune 10 Health plan companies and Healthcare providers. BroadPath essential business functions include customer experience, sales, and back-office operations. Overview:

BroadPath is immediately hiring a PPO Claims Processor to join our team. Our PPO Claims Processor will review denials and appeals to determine accuracy and to obtain additional information for resolution. The PPO Claims Processor will perform multiple task to complete proper account management.

Responsibilities:

• Conduct thorough reviews of claim denials and incorrect payments to identify potential grounds for appeal. This may involve consulting various guidelines and reference tools such as CPT, ICD9, ICD10, HCPC, medical terminology manuals, Correct Coding Initiative Edits, Medicare Fee Schedule, and modifier rules.
• Investigate claims that necessitate a deeper understanding of rules and processes, demonstrating proficiency in processing both clean and unclean claims.
• Utilize electronic claim editing systems to verify the accuracy and completeness of all necessary information prior to submission to payers.
• Accurately post insurance and patient payments, ensuring proper account management by applying correct denial codes.
• Engage in effective communication with physician offices to gather additional information required for resolving edits or appealing denied claims.
• Manage and resolve correspondence from insurance providers and patients promptly and professionally.
• Retrieve all essential information to assess the validity of refund requests.
• Assist in the preparation and mailing of patient statements.
• Monitor the EPIC billing system setup to ensure adherence to all pertinent payer billing requirements.
• Execute assigned tasks with precision and within specified timelines.
• Attend departmental, unit, and other relevant meetings as necessary.
• Maintain readiness to appear on camera upon request.

Qualifications:

• Exceptional customer service and communication skills
• Ability to handle and use prior knowledge to process Health Insurance claims from providers and payers
• Demonstrated ability to manage multiple priorities and deadlines
• Ability to quickly identify reasons for unpaid claims on patient accounts
• Effectively create communication for appeals by providing appropriate documentation for resolution
• Adhere to revenue cycle process on payer and governmental regulations
• Exceptional communication skills to resolve unpaid claims and obtain necessary information to resolve the account.
• Ability to communicate effectively with patients regarding their accounts.

Systems Experience Required:

• IDC 10 Code knowledge is required. ( ICD Code 9 knowledge is also acceptable)

Preferred Qualifications:

• 1-2 year claims processing experience ( please note this is not the same as claims billing)
• Experience in Adjustments, Adjudication and Provider Dispute Resolution ( PDR) also acceptable
• Epic Tapestry highly preferred

Diversity Statement: At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Information :

• Company : BroadPath
• Position : PPO Claims Processor
• Location : Remote
• Country : US

How to Submit an Application:

After reading and knowing the criteria and minimum requirements for qualifications that have been explained from the PPO Claims Processor job info – BroadPath Remote above, thus jobseekers who feel they have not met the requirements including education, age, etc. and really feel interested in the latest job vacancies PPO Claims Processor job info – BroadPath Remote in 24-04-2024 above, should as soon as possible complete and compile a job application file such as a job application letter, CV or curriculum vitae, FC diploma and transcripts and other supplements as described above, in order to register and take part in the admission selection for new employees in the company referred to, sent via the Next Page link below.