Claims Inquiry Representative

Summary

Join Integra Partners as a dedicated professional responsible for responding to web-form inquiries from provider/plan partners, reviewing DME claims for billing accuracy, and investigating and resolving client issues. You will maintain accurate documentation, ensure compliance with all applicable regulations, and meet daily productivity goals. This role requires former medical billing experience, strong computer skills, familiarity with medical terminology and claim forms, and the ability to work independently within a team environment. Integra Partners offers a competitive compensation package including an annual bonus program, 401(k) with company match, comprehensive health benefits, paid time off, parental leave, and various other perks. Remote opportunities are available in select states.

Requirements

• High school diploma
• Former medical billing experience
• Strong computer/keyboarding skills – including all Microsoft Office applications (Word, Excel, Outlook, etc.) with an ability to learn new programs where applicable
• Familiarity with 1500 claim forms and DMEPOS services
• Familiarity with ICD-10, HCPCS, and medical terminology
• Ability to correctly read and assess medical documents and resources
• Strong attention to detail
• Self-motivation to use available resources to investigate and problem solve
• Ability to meet consistent and punctual attendance expectations
• Commitment to adding value and contributing positively to the company and department
• Reliability and meeting attendance expectations

Responsibilities

• Reply to web-form inquiries submitted to Integra Partners from provider/plan partners
• Review DME claims for billing accuracy
• Investigate root cause of issues and deliver solutions to clients in a succinct, professional, and timely manner
• Maintain appropriate documentation and account records
• Ensure all work is in compliance with all legal, regulatory, and internal Integra policies and procedures, including HIPAA compliance
• Work with multiple health plan payors and remain flexible in day-to-day assignments
• Respond professionally and thoroughly to provider inquiries in a timely manner
• Use available resources to investigate and problem solve
• Perform duties in compliance with State and Federal regulations and the policies and procedures of Integra Partners and our clients
• Follow written and verbal directions
• Meet consistent and punctual attendance expectations
• Be flexible and willing to adapt to a changing environment
• Add value and contribute positively to the company and department
• Meet daily productivity goals at or above the current production metric
• Maintain a minimum bandwidth internet service of 200 MPS download speed
• Maintain a climate of teamwork and collaborative problem solving
• Perform other duties as assigned

Preferred Qualifications

• Strong organizational and critical thinking skills
• Motivated and able to work independently within a fast-paced, team environment

Benefits

• Competitive compensation and annual bonus program
• 401(k) retirement program with company match
• Company-paid life insurance
• Company-paid short term disability coverage (location restrictions may apply)
• Medical, Vision, and Dental benefits
• Paid Time Off (PTO)
• Paid Parental Leave
• Sick Time
• Paid company holidays and floating holidays
• Quarterly company-sponsored events
• Health and wellness programs
• Career development opportunities
• Remote Opportunities