Priority Claims Specialist II

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?

The Priority Claims Specialist - Remote will ensure payment for services provided is accurate, timely and fully documented. Provide efficient cash collection through excellent reimbursement practices while ensuring compliance with relevant laws, regulations and established Hanger policies and compliance programs. Provides strict adherence to adjustment, refund and write-off policies/procedures as outlined in Hanger Clinic Standard Operating Procedures. Maintain exceptional support and communication with all partners, internal and external.

This is a high-dollar medical collections role operating within a Centralized Revenue Cycle Team. This is a full time, remote opportunity. Schedule will be Monday - Friday day shift

Your Impact

Responsibilities for the role will include: 

• Maintain a working knowledge and understanding of DMEOPS CPT and ICD-10 codes.
• Utilize the company billing and collections system to identify and resolve any claims that have been unpaid, short paid and/or denied.
• Review EOB's and other correspondence from insurance companies for correct reimbursement according to rules and regulations and contract terms.
• Follow up with insurance companies by online portal, phone, email and/or fax.
• Identify billing errors and submitted corrected claims insurance carriers.
• Provide timely and accurate follow up on accounts until they are resolved.
• File and follow up on appeals and disputes.
• Communicate identified AR issues that may cause payment delays or write offs to management.
• Document all findings with clear and concise detail. 
• Research insurance guidelines and manuals for additional information.
• Perform adjustments in the system as needed.
• Submit medical records upon request.
• Resolves outstanding accounts receivable problems. Respond to and resolve inquiries …