Healthcare CSR (Billing) - Remote - Up to 35K

We are looking for CSRs for a client in the Healthcare Industry. This role is on a REMOTE setup and follows a Night Shift Schedule. Salary pays up to 35K Package Minimum requirement of at least 3 years of Healthcare experience in a BPO setup Essential Duties and Responsibilities: - Processes opportunities, such as verifying benefits, requesting authorization, & following up on auth-requests. - Completes data fields within the system with insurance information needed for claim submission, start & end dates of authorization, and others - Prepares correspondence to insurance companies, Health Care Professionals (HCPs) & other affiliates on behalf of patients, such as authorization requests, appeals & letters of agreement - Clearly documents all correspondence in the company databases. - Troubleshoots and seeks solutions to problems related to questions and concerns over authorization and claims. - When other team members are absent or not available, provides backup coverage for their territories/insurance/state. - Support education of team members on insurance verification, authorization, and claims - Analyze and investigate denied claims and find ways/resolution for payment. - Do outbound calls to different insurance companies to confirm information, submit/validate an authorization or claim submission/denials. - Identify denial patterns and escalate to management as appropriate with sufficient information for additional follow-up and/or root cause resolution. - Assumes and performs other duties as assigned. Required Qualifications: STRONG US HEALTHCARE COMPREHENSION - Must understand the intricacies of medical and pharmacy insurance coverage. - Must know and understand the difference between HMO, PPO, EPO, Indemnity, POS, Home Plans and Host Plans and be able to clearly communicate that to a patient and or another caregiver or medical professional. - Must understand different denial reasons and claim status. - Must understand CPT/HCPC codes, ICD 10, claim forms. - Ability to learn and retain the specific criteria and requirements for different insurance plan STRONG COMPUTER AND PHONE SKILLS - Must be able to create Word documents, work in Excel, use templates, use the internet, Outlook and work in a company created database - Must be pleasant and knowledgeable when speaking with insurance company representatives Preferred Qualifications: - 3 years of US HEALTHCARE experience Authorization and billing experience or insurance collections preferred. - Proven knowledge of and experience with ICD-9/10, HCPCS, and modifier coding. - Outstanding interpersonal, verbal, and written communications skills required. - Must be flexible and able to work in a fast-paced, heavy volume work environment. - Demonstrated computer, prioritization, and time management skills. - Experience working at insurance companies/payors or with medical device reimbursement for a start-up or new technology company or durable medical equipment setting is high desirable. Education and Experience Requirements: - Bachelors degree preferred. Language Skills: - Must be able to communicate effectively in English. - Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. - Ability to write routine reports and correspondence. - Ability to speak effectively before groups of customers or employees of organization. Originally posted on Himalayas