Medicare/Medicaid Claims Processor

Enjoy problem-solving, need a venue to display your creativity, and emerging technologies pique your interest; if so, Barrow Wise Consulting, LLC is for you. As a multi-disciplined leader, you understand the gifts that set you apart from everyone else. Demonstrate innovative solutions to our clients. Join Barrow Wise Consulting, LLC today.

Responsibilities:

The Medicaid/Medicare Claims Processor will support Barrow Wise's Illinois DHS project and perform the following duties:
• Review incoming claims for completeness, accuracy, and adherence to Medicare and Medicaid guidelines
• Enter claim data into the system accurately, ensuring all required fields are populated
• Verify patient eligibility for Medicare and Medicaid coverage
• Confirm that services rendered are covered under the respective programs
• Assign appropriate diagnosis and procedure codes to claims
• Calculate reimbursement amounts based on fee schedules and program rules
• Process claims through automated systems
• Identify and resolve any claim errors, discrepancies, or missing information
• Communicate with providers, patients, and other stakeholders regarding claim status, denials, and appeals
• Collaborate with internal teams to address claim-related inquiries
• Assist in handling claim appeals, including gathering necessary documentation and submitting appeals to Medicare and Medicaid
• Track and monitor the progress of appeals
• Ensure compliance with federal and state regulations related to claims processing
• Maintain accurate records and documentation of claims activities
• Participate in quality control processes to prevent payment errors and fraud
• Identify trends or patterns in claims data for process improvement
• Work remotely

An ideal candidate has the following:
• U.S. Citizenship
• Associate's Degree or Bachelor's degree
• 3 years of experience in healthcare claims processing, preferably with Medicare and Medicaid claims
• Knowledge and certification of ICD-10, CPT, and/or HCPCS coding
• Familiarity with claims adjudication software and electronic health records (EHR) systems
• Attention to detail and strong analytical abilities
• Excellent communication skills for interacting with providers and beneficiaries
• Ability to work independently and meet deadlines
• Understanding of healthcare billing and reimbursement processes
• Integrity and commitment to maintaining patient privacy
• Adaptability to changing regulations and guidelines
• Problem-solving mindset and customer service orientation

Join the team at Barrow Wise Consulting, LLC for a fulfilling and engaging experience! Our team is dedicated to providing innovative solutions to our clients in an ethical and diverse work environment. We offer competitive compensation packages, excellent benefits, and opportunities for growth and advancement. Barrow Wise is an equal-opportunity, drug-free employer committed to diversity in the workplace. Minority/Female/Disabled/Protected Veteran/LBGT are welcome to apply.

Our employees stand behind Barrow Wise's core values of integrity, quality, innovation, and diversity. We are confident that Barrow Wise's core values, business model, and team focus create positive career paths for our employees. Barrow Wise will continue to lead the industry in delivering new solutions to clients and persevere until the client is overjoyed.

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