Claims Consolidation Specialist

NaphCare has an excellent opportunity for a Claims Consolidation Specialist - BOP to join our Corporate Headquarters in Birmingham, AL. The Claims Consolidation Specialist is a vital position that is responsible for reviewing authorizations and medical records to obtain patient claims in order to invoice our various sites across the country within a contractual deadline. The Claims Consolidation Analyst will assist NaphCare with managing relationships with various providers while also multitasking to promote accuracy and timely receipt of medical claims.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare.

Responsibilities

Responsibilities:

• Review claims received by providers for submission to claims processing.
• Review authorization and medical records in order to identify services rendered and expected claims.
• Utilize medical terminology knowledge to review medical records and authorization scenarios.
• Develop and maintain provider billing contacts to pursue claims for all authorizations.
• Receive statements and ensure that authorizations have been loaded to match the corresponding statements.
• Demonstrate an ability to prioritize, meet deadlines, and multitask while promoting efficiency and effectiveness within daily workload.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
• Additional duties and specific projects as assigned.
  
  

Requirements

Qualifications

• Associate's degree or higher or equivalent work experience.
• Minimum of two (2) years of recent experience in claims processing and medical records review.
• Working knowledge of medical terminology and medical billing.
• Specific experience working with UBs and 1500s is required.
• Medical billing, claims processing/adjudication, medical records review, and/or coding experience preferred.
• Familiarity with CPT codes, E/M codes and REV codes.
• Proficiency in Microsoft Office Suite, Excel and Outlook capabilities with strong written and verbal communication skills are also require d.
  
  

This position is a hybrid position of in office days and work from home days. Approximately 7 in office days per month. Subject to change.

We know you may have questions before applying. To speak to a recruiter directly, email your questions and/or resume to CorporateHR@naphcare.com with the position and location you’re interested in.

Equal Opportunity Employer: disability/veteran