About The Client

One of Fortune's 2019 Best Places to Work. It's the state's only healthcare provider to make the list for the 19th time. This recognition is based on employee ratings of their workplace culture, including trust in leaders, job pride, and co-worker camaraderie. Patients rate us highly. Our medical expertise brings international patients and their families to Miami.

Our success derives from a company-wide culture of excellence and dedication. Our quality comes from their kindness, compassion, and dedication to clinical and service excellence.

Position will be fully remote with the need to be flexible if on-site team building were to be scheduled.
This position will be doing physician payments, reconciliation of provider payments, physician inquires, and running reports.

Job Responsibilities:

• Responsible for system-wide Claims Management and Third Party Administrative (TPA) tasks.
• Accurate audits, claim analysis, payer collections, and medical claim adjudication are key duties.
• Establish and manage the PNS Contract Management Process.
• Team Lead(s) support Para-Claim Parathion solution management by assessing claim data for anomalies, trends, and inconsistencies.
• Responsible for all line-of-business physician claims appeal and reimbursement reconsideration.
• Helps Team Lead(s) and leadership enhance departmental processes.
• Helps department leaders and Team Lead with payment and reconciliation.

Job Qualifications:

• Requires an associate degree with a minimum of 6 months experience or High School Diploma with a minimum of 1-year experience.
• Minimum of 6 months’ experience required; 5 years preferred.
• Must understand revenue cycle and UB forms.
• Accounts payable/Accounts Receivable/Accounting experience.
• Must be highly detail oriented with skilled data entry.
• Preferred experience in the following areas - Power BI or Smart sheets experience, Certified Coder/Biller, Healthcare Background, Claims Experience