Description JOB SUMMARY Under the direction of the MedPro Claims Research Supervisor, the Claims Research Specialist II is responsible for performing the duties related to insurance follow up/collection and maintaining of accounts receivables. ESSENTIAL DUTIES AND RESPONSIBILITIES • Ability to work with major carriers (i.e. BCBS of FL, Medicare, Medicaid, etc.) accurately and efficiently. • Familiarity with and ability to work all carriers with the exception of “Special Accounts” (i.e. WC, MVA, etc.). • Work weekly claims worklist: Carrier specific worklist daily, No activity, Client Respond (Goal: 48 hours) • Work insurance requests. • Work correspondence. • Work rebilled HCFA claim forms. • Respond to questions from billing staff related to insurance or account A/R activity in a courteous and professional manner. • Communicate with Claims Research Supervisor on carrier trends • Perform error corrections. • Ability to effectively communicate via claim notes per MedPro policy and procedure. • Update patient accounts with the correct insurance information. • Refile coding denials with appropriate material received from the Consultant Practice Manager (CPM) and/or coders. • Complete assigned projects within deadlines, as directed by the Claims Research Supervisor. • Perform daily functions with minimum guidance from Claims Research Supervisor. • Other duties as assigned. CORPORATE CULTURE RESPONSIBILITIES • Follow established corporate and department-specific policies and procedures. • Attend all corporate and department-specific required training. • Uphold MCC’s Purpose, Values, and Vision. • Abide by MCC’s Corporate Culture Responsibilities. • Perform other duties as may be assigned cheerfully and willingly. Requirements EDUCATION/EXPERIENCE REQUIREMENTS • Minimum education requirement is high school diploma, or equivalent. • Minimum 1-year insurance billing experience or equivalent, and minimum 1-year medical billing software or equivalent. KNOWLEDGE, SKILLS AND ABILITIES • Ability to prioritize and manage multiple tasks. • Displays customer services skills, strong interpersonal skills, close attention to detail, excellent verbal and written communication skills, and basic math skills. • Be a person of integrity and character, willing to embrace change and make a positive impact in the lives of patients and co-workers. • Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner. • Displays computer proficiency (i.e. PC Windows, MS Office) and ability to quickly learn new applications. • Acceptable typing speed and accuracy with ten-key by touch skills. • Proficient in use of English language both in written and verbal communication. • Must be able to communicate with individuals of varying socio-economic backgrounds. • Must be committed to the protection of confidential information, records and/or reports. • Possess strong critical thinking and analytical skills. PHYSICAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS • Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally) • Standing/Walking: Occasionally; activity exists up to 1/3 of the time • Keyboarding/Dexterity: Frequently; activity exists from ¾ of the time • Ability to look at a computer screen for extended periods. • Ability to perform constant repetitive hands and finger motions. • Ability to maintain focus while working in close proximity to others. • Talking (Must be able to effectively communicate verbally): Yes • Seeing: Yes • Hearing: Yes EMOTIONAL REQUIREMENTS OF THE ESSENTIAL JOB FUNCTIONS • Must exhibit stable work behaviors daily. • Must possess adequate individual coping skills. • Ability to remain calm and professional regardless of workload or time constraints. • Must be able to work under stress and remain calm and professional. WORK ENVIRONMENT • Office environment. • Exposed to frequent and constant interruptions in daily functions/schedule. • May be required to work extended hours to meet department needs.