Overview
Medical Claims Clerk Jobs in Fort Gratiot Township at Sunrise PACE (Region 7 AAA)
Medical Claims Clerk
Region VII AAA/Sunrise PACE is accepting applications for a highly motivated Medical Claims Clerk. Choose a challenging and rewarding career where you can enjoy a deep sense of personal satisfaction by making a positive and meaningful difference in the lives of others. This position will be located at our Sunrise PACE location in Fort Gratiot, MI.
The Company: Region VII Area Agency on Aging is a non-profit organization that helps seniors, adults with disabilities and their families have greater independence in their homes and communities and is known for the great care we take with clients and employees alike. We believe in advocating, planning, developing, and supporting a comprehensive system of quality care and services designed to achieve the optimum level of health, well-being, and independence of people as they age. Sunrise PACE is a Program of All-Inclusive Care for the Elderly, an alternative to nursing home living. The services provided by the Sunrise PACE program will enable our elderly participants to age in place in their home and community.
PURPOSE OF POSITION: The Medical Claims Clerk is responsible for accurately preparing, submitting and processing insurance claims by reviewing submitted documentation, verifying information, calculating benefits, and determining coverage eligibility while maintaining accurate records and providing customer service regarding claim status.
RESPONSIBILITES AND DUTIES:
Ensure appropriate authorizations exist for claims received.
Receiving and logging new insurance claims, ensuring all necessary information is present
Preparing and sending invoices or claims for payment.
Examining claims forms, supporting documentation for accuracy and completeness.
Acting as a liaison between medical offices and participants; reaching out to gather any required additional information needed
Handling confidential information and abiding by HIPAA laws.
Conduct internal audits, assist with audit prep and research for organizational audits.
Verifying participants’ insurance coverage and eligibility.
Answering participants’ billing and payment questions in a timely, kind, and supportive manner.
Managing account payments and maintaining records of received payments.
Maintaining detailed claim files with accurate documentation including notes and correspondence
Prepare and submit claims for payment.
Follow up on unpaid claims and manage collections.
Ensure compliance with federal and state laws, as well as program policies.
Resolve any discrepancies or errors.
Maintain confidentiality and security of participant data.
Communicate effectively with physicians and other healthcare professionals.
Business office duties such as completing and processing purchase orders, handling company credit card and maintaining petty cash for location.
QUALIFICATIONS AND SKILLS:
Proven work experience as a Coding and Billing Specialist, Claims Clerk, or similar role in the healthcare industry
Proficiency in computer applications, including claims processing software
Knowledge of medical terminology and familiarity with claims processing procedures
Excellent attention to detail and ability to work with complex information
Basic understanding of insurance policies, coverage terms and applicable regulations
Ability to maintain patient confidentiality.
High school diploma or equivalent
Strong administrative and organizational skills.
Must have accurate computer input skills, be proficient in the use of MS office applications and the ability to read and interpret medical supporting documentation.
Possess a high degree of accuracy, ability to solve practical problems, ability to work well with others in a professional manner.
Excellent communication skills, both written and verbal
Why join our Team?
Medical, Dental and Vision Insurance Offered (Premiums 100% Employer Paid)
Health Savings Accounts (Company Contributing)
Competitive 401K Retirement Plan with Generous Company Contribution
Short Term/Long Term Disability (Company Paid)
Paid Time Off
Paid Company Holidays
Life Insurance (Company Paid)
Exceptional Work Environment where all team members are valued
OSHA CATEGORY: This position in the regular course of business would not encounter any tasks or situations involving exposure to bodily fluids.
PHYSICAL DEMANDS: 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.While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to sit and use hands and fingers, handle or feel objects, tools or controls. The employee is occasionally required to stand and walk. The employee must be able to travel in all kinds of weather.While performing the duties of this job, the employee is required to frequently move up to 50 pounds and perform physical demands expected while providing medical care for an elderly population. Specific vision abilities required by this job include close vision, distance vision and the ability to focus. Region VII Area Agency on Aging/PACE is an Equal Employment Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, sexual orientation, gender identity, disability or protected veteran status. Region VII Area Agency on Aging/PACE is an EEO employer-M/F/Vets/Disabled
Job Type: Full-time
Pay: From $19.00 per hour
Expected hours: 37.5 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Health savings account
Life insurance
Paid time off
Tuition reimbursement
Vision insurance
Schedule:
8 hour shift
Monday to Friday
Work Location: In person
Title: Medical Claims Clerk
Company: Sunrise PACE (Region 7 AAA)
Location: Fort Gratiot Township
