Claims Specialist I
About the position
Grace Health is expanding and is currently seeking a Claims Specialist I to join our team. This full-time position is based at our facility located at 181 Emmett St W, Battle Creek, MI 49037. The ideal candidate will possess knowledge of charge entries, billing, and medical coding. We offer competitive wages based on experience and provide up to 3 weeks of paid time off (PTO) in the first year. One of the key benefits of this role is that it does not require working nights or weekends, allowing for a better work-life balance. Additionally, employees will enjoy paid holidays and a comprehensive benefits package that includes medical, vision, dental, life, and disability insurance, as well as a 401(k) matching program. In this role, the Claims Specialist I will be responsible for reviewing procedure and diagnosis codes submitted by providers, entering charges into the Practice Management System, and handling correspondence related to patient accounts. The specialist will also assist patients with inquiries regarding billing procedures and ensure that claims are produced on a regular schedule to Medicare, Medicaid, insurance carriers, and other third-party payers to facilitate prompt payment. Keeping abreast of various insurance regulations is crucial, as is making recommendations concerning accounts that may need to be written off or turned over for collection. The position also involves assisting patients with the application process for the schedule of discounts program and facilitating prior authorization for dental procedures. The Claims Specialist I will manage the Senior Millage Program, tracking and reporting as necessary, and will work on dental tasks submitted by a third-party billing company. Participation in professional development activities is encouraged to enhance skills and knowledge in the field.
Responsibilities
Enters charges into the Practice Management system submitted from Dental provider.
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Acquires patient billing information from patients and source documents.
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Produces claims on a regular schedule to Medicare, Medicaid, insurance carriers, and other third-party payers to ensure prompt payment.
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Keeps abreast of the various insurance regulations.
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Makes recommendations concerning accounts to be written off or turned over for collection.
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Enters all actions related to patient's account into the Practice Management System as a permanent record.
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Assists patients with the application process for the schedule of discounts program.
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Facilitates prior authorization for dental procedures.
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Manages Senior Millage Program, tracking and reporting.
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Works on dental tasks submitted by third-party billing company (RCM).
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Participates in professional development activities.
Requirements
High school diploma or GED required.
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Entry level, 0-3 years coding and/or claims processing experience in a health care organization.
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Dental billing experience preferred.
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CPC or similar credentials preferred, although not required.
Nice-to-haves
Benefits
401(k) matching
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Dental insurance
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Disability insurance
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Health insurance
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Paid time off
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Vision insurance
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Wellness program
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