Offer summary

Qualifications:

Proven experience as a Medical Billing Specialist., Knowledge of insurance policies including HMO/PPO, Medicare, and Medicaid., Familiarity with medical terminology and healthcare billing processes., Strong attention to detail and excellent communication skills..

Key responsibilities:

Ensure accurate billing for patients and insurance companies, processing payments timely.

Analyze data and manage denial processes effectively.

Negotiate with payers and resolve payment discrepancies.

Coordinate necessary documentation to expedite insurance claims.

Job description

This is a remote position.

Schedule: Monday to Friday, 8:30 AM - 5:30 PM with 1 hour unpaid lunch

Job Description:

The billing and coding Specialist will have strong attention to detail and analytical skills. The successful candidate will have a strong working knowledge of revenue cycle management and have a proven track record working in a healthcare practice environment in accounts receivable.

Responsibilities:

Ensure that patients and insurance companies are properly billed for all services, and that payments are received and processed in a timely manner.
Analyze excel spreadsheets and raw data.
Denial management process
Telephone insurance carrier/patient to seek resolution on accounts.
Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts.
Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from the payer.
Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims.
Identify trends in payer non-compliance and inform management if not able to resolve with payer.
Negotiate within specified guidelines with payers.
Ensure secondary carrier is appropriately billed or self-pay portion is pursued.
Follow up with appropriate staff to locate missing information.
Ensure accurate and timely billing of all outstanding account balances to the appropriate third-party payers and patient guarantors.
Maintain necessary logs
Participate in departmental meetings as necessary.

Qualifications:

Proven experience as a Medical Billing Specialist.
Knowledge of insurance policies, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Familiarity with medical terminology and experience with healthcare billing.
Proficiency in medical billing software.
Strong attention to detail and commitment to accuracy.
Excellent communication and problem-solving skills.
High school diploma; certification in medical billing or a related field is a plus.