Unified Physician Management

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Unpostable Specialist

at Unified Physician Management

Posted: 1/8/2019
Job Status: Full Time
Job Reference #: 673

Job Description

The Unpostable Specialist is responsible for processing the unpostable dashboard.  The position is responsible for "non" claim situations, and any unresolved claims issues that may arise directly from the Care Center.  There is an expectation of consistent communication via telephone and/or email to multiple entities (internally & externally) to resolve these issues. Duties include but are not limited to:

  • Processes “unpostables Dashboard” (i.e., payment or RA missing or not clear) in Athena Software          
  • Processes “non” claim situations (i.e., recoupment of payment for given clinics from different CC’s paid claims) in Athena                
  • Record Incentive payments  received                    
  • BYOLB process “Download Non-Athena Remittance”
  • Manages Payspan (pulling remits from payer site) 

Skills/ Requirements 

  • High school diploma or equivalent
  • Minimum of 5 years experience interpreting insurance explanation of benefits, plan benefits, and patient benefits/liability
  • Minimum of 5 years experience working with medical claims (HCFA 1500, UB04, UB92), insurance billing, payment posting, insurance collections, appeals, and medical records requirements/requests
  • Must possess excellent customer service skills communicating logically and clearly (verbally and in writing)
  • Experience and knowledge of insurance payer websites (e-appeals & verification of eligibility)
  • Experience with Microsoft Office & proficiency in data entry
  • Knowledge of Insurance guidelines and contracting information according to industry standards
  • Knowledge of Medical Billing & Coding or Certification is a plus
  • Knowledge of governmental insurance especially Medicare and Medicaid according to industry standards