Claims Specialist

Full Time
West End, NC 27376
$42,000 - $45,181 a year
Posted
Job description

Location: West End

Salary Hiring Range: $42,000- $45,181

Positions are remote or hybrid.

Sandhills Center is a Local Management Entity-Managed Care Organization (LME-MCO) serving

people in eleven counties in central North Carolina. We have network of providers who offer

treatment and support for mental health, substance abuse, and intellectual and developmental

disabilities.

Duties:

  • This position will maintain member accounts for contract provider services.
  • Follow-up on all uncollected billing, analyze and gather data for re-billing and/or resolution of

claims.

  • Collect paybacks and/or recoupments from providers and process refunds if research

determines service was not billable.

  • Compile a payment packet for contract providers to meet payment guidelines as indicated in

the State contract.

Minimum Requirements:

  • Graduation from High School or equivalent required with either
  • Two years of college business accounting or bookkeeping coursework
  • Or, Two years of highly relevant accounting experience in an accounting office

Knowledge of Medicaid/State Billing guidelines, Medicare, Third Party and State/DHB contracts.

knowledge of HCFA1500, UB04 claims requirements and knowledge of CPT, HCPCS, ICD-10 coding,

and diagnosis related to claims submitted. Proficient use of Microsoft Excel and Access.

Benefits:

  • Local Government Retirement Plan
  • 401k with a 3% match
  • Paid Vacation, Sick, and Holiday pay
  • Medical, Dental, Vision and Disability Coverage
  • Life Insurance
  • Flexible Spending Account

EOE

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