Claim Status Review (CSR) Specialist

Claim Status Review (CSR) Specialist is a resource that will review claims that have aged from 0-120 days for an assigned account to ensure it has successfully reached a payer and is being positioned to be paid in the quickest possible time

• Claim Status Review (CSR) Specialist

  Claim Status Review (CSR) Specialist is a resource that will review claims that have aged from 0-120 days for an assigned account to ensure it has successfully reached a payer and is being positioned to be paid in the quickest possible time. Upon review, a CSR Specialist will provide a detailed claim note, claim reference number, and update the CollaborateMD charge status to reflect their findings. CSR duties are described below:

  Job Duties:

  • Working Insurance Call cycles for claims aged 0-120 days
  • Use payer portals and call insurance companies for claims’ statuses
  • Create claim notes, add claim references numbers and update CMD charge statuses appropriately
  • Send necessary emails to designated email groups
  • Identify all denied claims and send to appropriate/assigned Insurance Collector for the account
  • Follow up on claims where Medical Records were submitted and attached to claim with payers
  • Maintains patient confidentiality by following the HIPAA Compliance Plan established by the practice.
  • Attends all meetings as requested and performs any additional duties as requested by Executive Management.
  • Adheres to all company policies and procedures

   

  Key Competencies

  Critical thinking, decision-making ability and sound judgement.

  Excellent organizational and time management skills.

  Flexibility and capacity to adapt quickly to changing situations.

  Ability to work effectively and harmoniously in work teams and instill confidence in others.

  High level of accuracy and thoroughness in all aspects of work.

  Strong professional maturity, initiative, and sound discipline.

  Good oral and written communication skills suited for diverse internal and external audiences.

   

  Job Requirements:

  • A Bachelor's Degree in Accounting, Banking, Business Administration or related field
  • At least 3 years’ experience in Accounting or any other related field
  • Proven successful supervisory skills.
  • Flexibility, ability to work under pressure, meet deadlines and work on shifts
  • Excellent computer skills
  • Great attention to details
  • Excellent interpersonal skills
  • Ability to communicate with persons at all levels

   

   

  An Equal Opportunity Employer