Claims Processing Clerk
Founded in 2003, Praesum Healthcare provides administrative services for healthcare providers spanning key geographical locations throughout the country. Praesum has serviced over 49,000 patients in various stages of health care services. With an established business model, strong finances, expert industry management team, and proven networking capabilities, Praesum looks to prosper in the $11.6 billion industry (2014 industry revenue forecast). Separate from its networks of providers, Praesum currently runs and operates eight drug and alcohol detoxification centers in Florida, New Jersey, Georgia and Massachusetts, as well as eleven outpatient counseling centers in New Jersey and New York.
The Claims Processing Clerk will review and audit patient medical records and assign codes to diagnoses and procedures performed by service providers. This position will prepare all billing forms to send to 3rd party biller for timely insurance claim submission. This position will ensure accuracy encompassing billing, coding and insurance requirements, in addition to state and federal laws surrounding Protected Health Information (PHI) and HIPPA, 42CFR, Part 2.
• Organize and manage patients' health information data
• Prepares daily charges and claims to be submitted electronically to clearing house and insurance carriers
• Accounts Receivable follow up with insurance carriers
• Claim denial management with electronic clearing house
• Utilizes 3 different code sets: CPT, HCPCS, and ICD-10 for appropriate billing to insurance carriers
• Release information to persons and agencies according to state and federal regulations
• Possess the ability to critically analyze documentation, assigning proper codes.
• High School Diploma or GED equivalent
• AA Degree or Vocational training preferred in a related field
• A minimum of 2 years of office or related healthcare industry experience
• Individual must be computer literate with proficiency in Microsoft Office applications.
• Full Time 8:30 am to 5:00 pm M-F
• May or may not include weekends
• Medical Insurance
• Dental/Vision Insurance
• $25,000.00 Basic Life Insurance
• Accrued PTO Plan
• Education reimbursement
*** This job does NOT sponsor visa's and we are unable to consider out of country applicants ***
If you are interested in this opportunity or know someone that you respect who would be a good fit for this position, please email:
Chase@praesumhealthcare.com Director of Talent Acquisition, Chase
RDavis@praesumhealthcare.com Executive Recruiter, Ray