Job Description

NaphCare has an excellent opportunity for a Claims Consolidation Specialist - BOP to join our Corporate Headquarters in Birmingham, AL . The Claims Consolidation Specialist is a vital position that is responsible for reviewing authorizations for medical services rendered and medical records to obtain patient claims in order to invoice various contracts across the country within contractual deadlines. The Claims Consolidation Specialist will assist NaphCare with managing relationships with various providers while also multitasking to promote accuracy and timely receipt of medical claims.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population and take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare.

NaphCare Benefits For Full-Time Employees Include

• Prescriptions free of charge through our health plan
• Health, dental & vision insurance that starts day one!
• Lowest Cost Benefits! $44 for single, $105 for family!
• Employment Assistance Program (EAP) services
• 100% vested 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• On-site education
• Free Continuing Education!
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up-to-date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

Responsibilities

Responsibilities:

• Review claims received for submission to claims processing.
• Review authorization and medical records in order to identify services rendered and expected claims.
• Utilize advanced knowledge of medical terminology to while reviewing claims.
• Develop and maintain provider billing contacts to pursue claims for all authorizations.
• Receive statements and ensure that authorizations have been loaded to match the corresponding statements.
• Demonstrate an ability to prioritize, meet deadlines, and multitask while promoting efficiency and effectiveness within daily workload.
• Exhibit a high comfort level in working with large volumes of data.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the claims retrieval and review process.
• Additional duties and specific projects as assigned.

Qualifications

Qualifications for Claims Consolidation Specialist:

• Associate's degree or higher or equivalent work experience.
• Minimum of two (2) years of recent experience in claims processing and medical records review.
• Working knowledge of medical terminology and medical billing.
• Specific experience working with UBs and 1500s is required.
• Medical billing, claims processing/adjudication, medical records review experience required.
• Familiarity with CPT codes, E/M codes and REV codes preferred.
• Proficiency in Microsoft Office Suite, specifically Outlook and Excel worksheet capabilities along with strong written and verbal communication skills are also required.
• Ability to learn software systems specific to NaphCare for this specific position quickly.

This position is a hybrid position of in office days and work from home days. Approximately 7 in office days per month. Subject to change.

Equal Opportunity Employer: disability/veteran

Outstanding Benefits Package

NaphCare offers competitive benefits, including health, prescription, dental, Employment Assistance Program (EAP) services, vision and 401(k). NaphCare offers term life insurance at no cost to the employee and provides PTO, paid holidays and an array of voluntary benefits. Employees enrolled in our health insurance program receive prescriptions free of charge when filled at our in-house pharmacy or mail order program.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job

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