Products
NPL is the leading provider of customized complex rehabilitation technology solutions within Ohio. Our expert team of Assistive Technology Professionals (ATP) collaborates with the patient, therapist, and patient's health care providers to develop a wheelchair solution that addresses each patient's unique conditions and challenges.
NPL works with the industry's leading providers of wheelchair technologies including
A/R and Claims
Specialist
NPL Home Medical is one of the industry leaders in providing custom wheelchairs in Ohio. Since 1993, our promise has always been to deliver the highest quality service to both patients and medical professionals while creating a wheelchair solution that addresses our customer’s unique needs. At NPL, responding to our customer’s needs is always Job #1.
About This Career Opportunity:
We have an exciting opportunity for you to join our team as a Accounts Receivable & Claims Specialist. In this position, you will play a vital role in delivering our “Service First” value proposition to our patients, therapists, and physician stake holders. As a member of our team, you will have an opportunity for personal and professional growth and career advancement as we build on our consecutive years of significant growth. We are also proud to have been recognized for our amazing workplace and culture, including being selected as one of the:
• Best Employers in Ohio by Crain’s Magazine in 2021, 2022, 2023, and 2024
• Top Employers in Cleveland by Cleveland.com in 2022, 2023, and 2024
• Top Workplace’s in NE Ohio by North Coast 99, 2022, and 2023
Do not miss this opportunity to find career success with a forward thinking, entrepreneurial, and growing company.
Summary:
The Accounts Receivable & Claims Specialist is responsible for responding to custom wheelchair claim denials. This includes understanding the reasons for disputing the insurance claim, remedying as required, and managing the appeal process. The Accounts Receivable & Claims Specialist must be highly organized and an effective communicator both with our billing/claims team and insurance providers. Additionally, this individual should have strong computer skills to include creation and utilization of excel spreadsheets and use of our claims management software. This position requires communication, collaboration, attention-to-detail, and organization skills.
Main responsibilities:
-
Submits all claims for Medicaid, Commercial, and Managed Care and third-party payers per payer requirements
-
Resolves all rejections errors/edits at time of claim submission
-
Researches and analyzes denied claims, including determining the root cause of denials and developing a plan for resolution
-
Contacts insurance carriers through website, email or telephone to resolve aged receivables
-
Analyzes and resolves moderately complex insurance denials including coding review to prevent errors within the appeals process
-
Prioritizes activities to overturn denials in a timely manner
-
Identifies and pursues opportunities for reduction in denials
-
Researches, responds, and documents insurer and patient correspondence/inquiry notes regarding coverage, benefits, and reimbursement on all insurance accounts
-
Researches rejections included in Explanation of Benefits (EOB’s) for resolution and responds appropriately
-
Makes management aware of any issues or changes in the billing system, insurance carriers, and/or networks
-
Other duties as assigned
Qualifications and Experiences
-
Ten (10) years claims experience; preferably in the area of durable medical equipment
-
Experience using Brightree claims management software a plus
-
Ability to create and utilize excel spreadsheets
-
Must have experience with Microsoft Office applications
-
Must be able to demonstrate strong organizational and time management skills
-
Strong interpersonal communication
-
Evidence of strong problem-solving skills, while using a flexible and collaborative approach
-
Capable of working independently with little supervision
Working Conditions:
While performing the duties of this Job, the employee is regularly required to stand; sit and talk or hear. The employee is occasionally required to walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close and distance vision.
NPL Home Medical is an Equal Opportunity Employer. NPL Home Medical does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, gender identity or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.
Job Type: Full-time