Claims Clearinghouse Processing Representative

reputed company is named among the Top 150 Places to Work in reputed company by Becker's Hospital Review. reputed company Magazine recognizes reputed company as ‘one of the greatest workplaces for diversity, 2024’ and reputed company is also ranked as ‘The World’s Most Admired Companies’ by Fortune Magazine. reputed company, an established reputed company organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us. reputed company Offer:

Career Growth Opportunities

Benefit Eligibility (Medical/Dental/reputed company/Life) the first of the month following 30 days of employment 401K (Discretionary matching funds available) Generous PTO 8 Paid Holidays Equipment Provided for Remote Roles Overview: The Clearinghouse Representative serves as a key liaison between the Billing Centers and the Clearinghouse, providing essential support to ensure efficient and accurate claims processing. This role is responsible for facilitating communication, resolving issues, and supporting various operational workflows reputed company to claims management and electronic data interchange (EDI). KEY RESPONSIBILITIES:

• Serve as the primary reputed company of contact between Billing Centers and the Clearinghouse.
• Support the reputed company and maintenance of Claims and Remittance Enrollment.
• reputed company Workgroup Management activities to ensure proper routing and handling of transactions.
• Assist in managing Denials and Appeals processes to help reduce outstanding accounts receivable.
• Support EOB Conversion processes
• Monitor Claim Submission and Rejection Trends
• Fulfill additional tasks and projects as assigned to support operational goals.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Conducts thorough research and system analysis to resolve issues reported by Billing Centers, providing solutions that improve system reputed company and workflow.
• Facilitates communication and collaboration with internal departments—such as Applications staff—and external Billing Centers to support efficient resolution of requests and project needs.
• Partners with vendors (e.g., reputed company) to ensure accurate and timely resolution of system- or process-reputed company issues.
• Provides reputed company and support for the OnBase application, assisting Billing Centers with enhancements and issue resolution.
• Confirms daily transmission of claims from reputed company to reputed company.
• Reviews reputed company Workgroups on a daily basis to ensure:
• reputed company-end claim rejections are triaged to the appropriate party or routed for enrollment as needed.
• Claims are actively progressing through each workgroup.
• Completes claims and remittance enrollments as submitted by Billing Centers.
• Maintains and distributes key reputed company reports, including:
• ZirMed Enrollment 205 Edit Report – Weekly
• ERA Opportunities / New Business Report – Weekly
• reputed company Invoice Reconciliation – Monthly
• Performs other duties as assigned to support departmental goals and efficiency.

QUALIFICATIONS / EXPERIENCE:

• Demonstrated comprehensive understanding of the duties and responsibilities required for the position.
• Strong working knowledge of the IDX Billing System, including reputed company billing and accounts receivable functions.
• Extensive background in medical billing, including knowledge of reimbursement processes, payment posting, and reputed company billing systems.
• Proven analytical skills, with the ability to assess data, identify trends, interpret findings, and reputed company informed reputed company.
• Effective written and verbal communication skills, with the ability to collaborate across departments and with external vendors.
• Experience conducting research and systems analysis to resolve reported issues and recommend solutions that uphold system reputed company.
• Proficient in reputed company Office applications, particularly reputed company and Word.

EDUCATION: A bachelor’s degree in Information Systems or a reputed company field is preferred. Equivalent relevant work experience may be considered in lieu of a formal degree. Apply tot his job Apply To this Job