Hanger, Inc. · 2 days ago
Priority Claims Specialist III
United States
Full-time
Remote
Senior Level
$20/hr - $25/hr
5+ years expHanger, Inc. is the world's premier provider of orthotic and prosthetic services and products. The Priority Claims Specialist III will ensure accurate and timely payment for services, manage cash collections, and maintain compliance with relevant laws and regulations while providing exceptional support and communication with partners.
Health CareHospitalMedical Device
Responsibilities
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 from customers or external collection resources
Primary focus is on complex denials and appeals
Review, monitor and resolve assigned encounters and all assigned reports
Identify issues attributing to account delinquency and discuss them with management as needed
Provide timely follow-up on all tasks
Effective communication with Patient Care Clinics related to collection efforts
Complete, review, and research any deficiency to ensure that any deficiency is properly addressed and resolved
Qualification
Required
High school education or equivalent
5+ years of related experience to include at least one of the following areas: Insurance reimbursement, medical policy, payor appeal requirements or patient collection laws
Experience in a medical office
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 from customers or external collection resources
Primary focus is on complex denials and appeals
Review, monitor and resolve assigned encounters and all assigned reports
Identify issues attributing to account delinquency and discuss them with management as needed
Provide timely follow-up on all tasks
Effective communication with Patient Care Clinics related to collection efforts
Complete, review, and research any deficiency to ensure that any deficiency is properly addressed and resolved
Preferred
Associate's degree
Experience with NextGen and/or OnBase
Licensed Medicare auditor or Certified Medical Audit Specialist
Benefits
Competitive Compensation Packages
8 Paid National Holidays & 4 additional Floating Holidays
PTO that includes Vacation and Sick time
Medical, Dental, and Vision Benefits
401k Savings and Retirement Plan
Paid Parental Bonding Leave for New Parents
Flexible Work Schedules and Part-time Opportunities
Generous Employee Referral Bonus Program
Mentorship Programs- Mentor and Mentee
Student Loan Repayment Assistance by Location
Relocation Assistance
Regional & National traveling CPO/CO/CP opportunities
Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest
Company
Hanger, Inc.
Headquartered in Austin, Texas, Hanger, Inc. is a leading provider of orthotic and prosthetic (O&P) patient care services and products.
5001-10000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2022-07-21Acquired
Leadership Team
Thomas Kiraly
Chief Financial Officer
Recent News
2025-10-10
Company data provided by crunchbase