Front End Specialist

Job Purpose:

Maintenance of filing electronic & paper claims as well as managing rejections. Report rejection trends to team leads/managers.

Responsibilities:

• Claims Processing as per client requirements

• Work Rejected & Queued Rejections

• Provide feedback to team lead regarding any positive & negative occurrences on accounts

• Maintain strict confidentiality within medical practice and HIPAA compliance.

• Maintain productivity standards and goals set by the department and/or manager.

• Maintain standard quality measures and goals.

• Attend Meetings as required and/or participate in various committees as required

• Other duties as assigned by, Team Lead, Manager, Director, VP RCM.

Required Skills:

• High school diploma/GED

• Preferably two years’ prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication, including but not limited to:

- Explanation of Benefit forms (EOB)

- Credit balances (discounts and refunds)

- Insurance carrier billing requirements

- Collections

- Familiarity of payer provider enrollment

- CPT & ICD10 Coding

Core Competencies:

Accountability and Self-Management

• Must be detail-oriented and organized

• A self – starter capable of tracking to deadlines and meeting goals with little supervision required

• A high level of analytical and problem solving skills is expected

Team Player

• Ability to work autonomously and as a team player

Communication

• Excellent communication, customer service, and organizational skills

• Strong verbal and written communications

Innovation and Problem Solving

• Attention to detail and moderate analytical and problem solving skills is expected

Computer Skills

• Must possess general office skills and computer knowledge

• Strong working knowledge of the Aprima PM practice management system and/or GE Centricity Business system and coordinating modules, is preferred

• MS Excel Spreadsheet software, MS Word Processing software

Physical Demands:

• May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies.

• Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary.

• Employee must participate to help maintain the desirable work environment created by the management and company officials.