Note: The job is a remote job and is open to candidates in USA. Transcend Health Solutions, LLC is seeking an experienced and detail-oriented MVA Claims Analyst to join their team. This role involves managing medical claims related to motor vehicle accidents, ensuring accurate billing and reimbursement while navigating complex insurance requirements.
Responsibilities
• Review and process medical claims related to motor vehicle accidents for submission to third-party liability and first party carriers
• Coordinate benefits with auto and health insurance plans, attorneys, and adjusters to ensure accurate billing and reimbursement
• Verify auto insurance coverages and eligibility to determine appropriate payer responsibility
• Investigate and resolve denials and underpayments through appeals, follow-up calls, and written correspondence
• Interpret Explanation of Benefits (EOBs) and remittance advices to determine claim status and next steps
• Communicate with healthcare providers, insurance companies, patients, and legal representatives to resolve claims efficiently
• Ensure compliance with jurisdictional rules for submitting medical records and billing information
• Maintain detailed documentation of claim activities for tracking and auditing purposes
• Draft appeal letters and escalate complex issues to management as needed
• Utilize medical terminology and coding accurately in claims processing
• Demonstrate exceptional attendance and ability to work independently while meeting performance metrics
• Uphold HIPAA guidelines and maintain confidentiality of sensitive information
Skills
• In-depth knowledge of various auto insurance coverage types (PIP, MedPay, Bodily Injury, Liability)
• Familiarity with medical billing terminology and proficient in interpreting EOBs
• Strong written communication skills for preparing effective appeals and correspondence
• Detail-oriented, analytical, and self-motivated mindset
• Excellent oral communication skills with a customer service-oriented approach
• Proven track record of punctuality and attendance
• Ability to multitask and prioritize tasks in a fast-paced, deadline-driven environment
• High School Diploma required; Bachelor's degree preferred or equivalent experience
• Minimum of 2 years' experience in medical billing or claims processing, preferably in MVA or liability claims
• Proficiency in Microsoft Office and experience with EHR or billing software
• Experience working with attorney liens or hospital lien statutes
• Understanding of coordination of benefits (COB) and subrogation processes
• Knowledge of state-specific MVA insurance regulations and claims procedures
• Familiarity with hospital revenue cycle practices
Company Overview
• Transcend Health Solutions specializes in revenue cycle management (RCM) services. It was founded in 2023, and is headquartered in Bradenton, Florida, US, with a workforce of 11-50 employees. Its website is https://transcendrcm.com/.
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