Payment Exceptions Specialist

Job Details

Type: Full-time – Nonexempt

General Description Including Key Performance Expectations:

All Payment Exceptions Specialists are responsible for the following performance expectations:

  • Review each claim on exception listing on dashboard to determine if the insurance company processed accurately per contract for each group assigned within 30 days of dashboard import
  • If insurance did not process correctly:
    • Appeal for additional payment and follow-up until appeal is completed
    • Enter an alert on the account of the correct allowed amount expected
  • If, after review, an overpayment was made per contract: Answer patient calls regarding estimates of anesthesia rates for the specified procedure code givenComplete all assigned work on a timely basis
    • Submit overpayment letters to the appropriate insurance company
    • Follow up until resolved
  • Work cooperatively to meet departmental or organizational goals by including others (inside and outside the team) in the process of solving problems and implementing solutions
  • Convey ideas in a clear, concise and open manner during oral and written communication

Work Experience Requirements:

  • 1 – 2 year(s) medical billing experience preferred
  • Ability to type more than 50 WPM
  • 10-Key
  • Ability to read and understand an explanation of benefits (EOB)

Compensation and Benefits:

  • Monday – Friday (Full-time)
  • Competitive Wages
  • Medical
  • Dental
  • Vision
  • 401(k)
  • Life Insurance

Tagged as: exceptions, payment exceptions, payments

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