Claims Auditor - Mesa in Mesa, AZ at NextCare Urgent Care

Date Posted: 4/28/2021

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Mesa, AZ
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    4/28/2021

Job Description

POSITION SUMMARY:

This position is responsible for auditing the billing and charge entry for the NextCare Clinics prior to billing the claims to the insurance companies.  It will involve running reports, correcting errors, entering information for tracking, checking for correct provider/supervising on charges, and reporting unusual findings to the Billing Manager. The position will also involve the transferring payments, correcting the charges and adjusting the contractual if needed in order to provide correct information before billing.  The position will also involve special projects as needed. 

ESSENTIAL FUNCTIONS:

  • Responsible for running daily reports and checking for correct information (provider, supervising, E&M codes, missing charges, pending charges, etc.) and entering notes on the reports to be able to report findings back to the clinics for training purposes.

  • Accountable for reviewing the charges and entering the correct information if needed.

  • Claims will need to be reviewed each day for the prior date of service and will need to be completed in a timely manner in order keep the claims flowing and not have a delay in billing times.

  • Perform daily the charge corrections and contractual adjustments that are needed.  Post batches daily as to not allow for errors in statements.

  • Will require exporting reports to excel, saving on the drive and inserting corrected information on the spreadsheets. 

  • Responsible for ensuring that the charge corrections are billed in a timely fashion.

  • Assist with claim resubmission projects when deemed necessary.

  • Treats patients and co-workers consistent with the NextCare Mission Statement, Vision, Values and Performance Standards.

  • Performs other related duties as assigned or described in Company policy.

Job Requirements

ESSENTIAL SKILLS AND EXPERIENCE:



Education:  Minimum of High School diploma or equivalent. 

Experience: Must have a minimum of three years of experience in billing and charge entry, payment entry, collections, and general understanding of contractual adjustments.  Experience with Managed Care contracts, Medicare and Medicaid.   Must have general computer knowledge and good working knowledge of Microsoft Excel.

VALUED BUT NOT REQUIRED SKILLS AND EXPERIENCE:

Experience:  Medical collections experience; Charge entry knowledge; NextGen software experience