Medical Claims Follow-Up Specialist - Chelmsford - 40 hours

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical practice locations in eastern Massachusetts. Atrius Health’s 645 physicians and primary care providers, along with 420 additional clinicians, work in close collaboration with hospital partners, community specialists and skilled nursing facilities. Our vision is to transform care to improve lives. Atrius Health provides high-quality, patient-centered, coordinated, cost effective care to every patient we serve. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives. Atrius Health is part of Optum, a health services company focused on building the leading value-based care system in the country.

SUMMARY

Under general supervision, is responsible for the follow up and resolution of all outstanding unpaid balances and denied claims for all payers. In accordance with department policies and procedures, responsibilities include but are not limited to: responding to payer correspondence, submitting appeals for denied claims including writing medical necessity appeals, reviewing claims for coding corrections, processing requests for insurance payment retractions, researching and resolving overpayments and investigating electronic claim rejections.

EDUCATION/LICENSES/CERTIFICATIONS

High School diploma or equivalency certificate (e.g. GED, HiSET, TASC Test) from an accredited institution or governmental unit required.

EXPERIENCE

Three years’ experience in physician medical billing, health plan claims administration or other health services related billing is required with specific experience in claim coding corrections and filing medical necessity related appeals.

SKILLS

Proficient knowledge of medical terminology and billing rules and regulations, claims resolution and HCPCS, ICD10 and CPT-4 coding required. Strong organizational and analytical skills, exceptional attention to detail and the ability to perform, with accuracy, multiple tasks simultaneously are required. Strong computer skills, effective written and verbal communication skills and the flexibility in adapting to changes in policies, regulations and procedures are essential.

Atrius Health is committed to a policy of non-discrimination and equal employment opportunity. All patients, employees, applicants, and other constituents of Atrius Health will be treated with respect and dignity regardless of race, national origin, gender, age, religion, disability, veteran status, marital/domestic partner status, parental status, sexual orientation and gender identity and/or expression, or other dimensions of diversity.

Benefits Include:

• Up to 8% company retirement contribution,

• Generous Paid Time Off

• 10 paid holidays,

• Paid professional development,

• Generous health and welfare benefit package.