ZoomCare
ZoomCare
ZoomCare — медициналық көмекті қолжетімді әрі ыңғайлы етуге бағытталған Тынық мұхитының солтүстік-батысындағы денсаулық сақтау қызметтерін ұсынушы компания. 2006 жылы негізі қаланған компания бөлшек денсаулық сақтау, шұғыл көмек, алғашқы медициналық-санитариялық көмек, жедел медициналық көмек және цифрлық денсаулық сақтау салаларында 50-ден астам клиника жұмысын жүргізеді. Пациентке бағдарланған моделі онлайн жазылуды, сол күні қабылдауға жазылуды және ұзартылған жұмыс уақытын біріктіріп, медициналық көмекке қол жеткізуді жеңілдетеді.

Insurance Billing and Follow-Up Specialist

Manage denied, unpaid, and underpaid insurance claims for ZoomCare, an urgent, primary, and specialty healthcare provider. Handle payer follow-up, corrected claims, appeals, and reimbursement resolution.

Сипаттама

  • Resolve unpaid and partially paid insurance claims by addressing outstanding balances and securing accurate reimbursement under payer guidelines.
  • Verify claim status through insurer portals, phone calls, and written correspondence.
  • Review denied and underpaid claims to determine root causes, recurring trends, and appropriate corrective actions.
  • Prepare and submit well-documented appeals within payer deadlines and procedural requirements.
  • File corrected claims with revised coding, supporting documentation, or demographic details as needed.
  • Record all claim follow-up work accurately in billing or revenue cycle management systems.
  • Partner with coding teams, clinical documentation specialists, and provider offices to investigate and correct discrepancies.
  • Track aging accounts and prioritize follow-up according to timely filing deadlines and payer response periods.
  • Escalate systemic problems and inefficient processes to management for review.
  • Achieve productivity and quality targets while following compliance and patient privacy requirements.
  • Complete additional duties as assigned.

Талаптар

  • Reside in Oregon or Washington.
  • High school diploma or equivalent required.
  • Associate degree in healthcare administration, business, or a related discipline preferred.
  • At least two years of medical billing experience, including professional billing and accounts receivable follow-up.
  • Working knowledge of CPT, HCPCS, and ICD-10 coding systems and their use in claim submission and reimbursement.
  • Experience using electronic billing systems and payer portals to track claims, denials, and appeals.
  • Understanding of insurance reimbursement methods, claim adjudication, and payer-specific requirements.
  • Working knowledge of medical terminology and healthcare documentation.
  • Strong analytical and problem-solving abilities.
  • Excellent written and verbal communication skills.
  • Exceptional attention to detail and accuracy, with the ability to manage competing tasks and meet deadlines in a fast-paced setting.
  • Patient-facing employees must receive required vaccinations, including Hepatitis B, MMR, PPD, Varicella, and TD/TDAP; all employees must receive COVID-19 vaccination as a condition of employment.

Артықшылықтар

  • Medical, dental, and vision coverage.
  • 401(k) plan with employer match.
  • Paid time off.
  • Paid holidays.
  • Paid parental leave.
  • Sabbatical program.
  • May qualify for additional compensation, including bonuses.
  • Medical or religious exemptions and reasonable accommodations may apply to required vaccinations.

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