"Alerted.org

Resp & Qualifications

PURPOSE:

This position ensures that the more complex accounts are accurately invoiced, reconciled and outstanding payments are collected so that the core system is correct, and the client is satisfied. In accomplishing its accountabilities, the position must interact and coordinate with accounts, subscribers, finance, systems and other internal CareFirst departments as well external parties.

This position is responsible for serving as point of contact for internal and external customers regarding all complex billing and collection issues. The associate will assist in the clarification and development of process improvements and inquiries, assure payments related to services from all sources are recorded and reconciled timely in order to maximize revenues. The incumbent may be required to assist with projects for upper management by providing analytical and reporting support for such purposes as: operational efficiency / quality metrics and productivity analysis, end-of-month accounts receivables reconciliation, and monthly account aging reports.

ESSENTIAL FUNCTIONS:

+ Researches and responds by telephone, or in writing to complex patient inquiries regarding billing issues and problems.

+ Reviews billing forms for accuracy and completeness before sending to payors.

+ Assists in the preparation of monthly billing and accounts receivable reports.

+ Assists with complex billing issues, including contacting insurance carriers to confirm patient eligibility and referral information.

+ Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner.

+ Adhere to HIPAA guidelines and other relevant state and federal regulations, and company policies regarding to compliance, integrity, patient privacy and ethical billing practices.

QUALIFICATIONS:

**Education Level:** High School Diploma or GED.

**Experience:** 3 years' experience in a Billing, membership enrollment, member services, claims operations or Finance role.

Knowledge, Skills and Abilities (KSAs)

+ Proficient in Microsoft Office applications.

+ Provide excellent customer service with a focus on department goals.

+ Works well in environment with firm deadlines; results oriented.

+ Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

**Salary Range:** $34,632 - $63,492

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Medicare/Medicaid Admin

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

REQNUMBER: 21453