Grundy Workforce Job Board Services: Submission #4443

Company Info
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Company Name: Midwest Orthopaedic Consultants 
Address:
10719 160th St
Orland Park, Illinois. 60467

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Website Address (Optional): https://orthoexperts.applicantpro.com/jobs/


Job Details
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Job Title: Medical Claims Review Representative
Job Location: 10719 160th St. Orland Park
Over 18 Required: Yes
Employment Type: Full Time
Work Shift: 1st
Rate: $19 - $24 an hour
Number of Positions: 1
Please Have Applicant: Apply Online
Job Description:
Review claims submissions for accuracy by confirming proper payer, authorizations, referrals and all other key billing components.
Follow clams from submission to payment using EMR analytics, reports, payer portals and other resources as necessary
Partner with third party billing company personnel to resolve billing issues and support the effort of submitting clean claims with any research in a timely and responsive manner
Review payer EOBs for a complete understanding of payments and assignment to patient responsibility.
Use your knowledge of health insurance claim processing, patient policies by payer and payer plan dynamics for commercial, governmental, worker's compensation, labor funds and others to assess accuracy of payments.
Work diligently to resolve denied/rejected claims by researching and determining the causes of the unpaid claims and making every effort to resolve the denial/rejection in order to promptly resubmit to the payer.
Respond to patient and/or insurer inquiries in a professional. timely efficient and knowledgeable fashion, ensuring HIPAA and MOC guidelines are followed. and /or refunds as necessary.
Other job tasks as necessary

Must be able to sit and work at a computer for extended periods of time
Requires manual finger dexterity and vision corrected to normal range
Must be able to lift 25 lbs

Job Requirements:
Experience using EMR, EHR and other healthcare/billing related systems to include Allscripts, Mod Med, EPIC, Exscribe, Health Ipass etc., Experience with web portals such as Availity
Proficiency using Microsoft Excel
Thorough knowledge of medical insurance terminology and payer explanation of benefits and experience working withmedical benefit plans department of labor for workers comp claims
Experience with patient assistance and government programs such as Medicare and Medicaid
Proficient at multitasking and managing competing priorities effectively.
Effective written and oral communication.
Minimum HS diploma, college degree desired but not required
Four years direct experience with core competencies

Lifting Requirements - 25+ lbs (unassisted): Yes
Lifting Requirements - 50+ lbs (unassisted): No
List Job Until: 10/27/2025


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