Medical Biller

OVERVIEW

The Baby Academy is revolutionising perinatal education across the United States through its unique content and inspirational educators. Positioning itself at the nexus of Ed-Tech and Med-Tech, The Baby Academy was founded in 2019 and is growing rapidly across the US with 18 full time staff and 82 educators.

The Baby Academy has incredibly ambitious growth plans across the US, and is seeking to built out its medical billing team. The role is all-encompassing and will challenge even the strongest candidate. We are looking for someone with the right combination of experience, intelligence and work ethic. Most importantly, we are looking for someone who can fit with the company culture of continuous improvement, high ethical standard and action-oriented style.

THE OPPORTUNITY

The Medical Billing Specialist will act as the critical business partner to the Vice President of Revenue Cycle Management in driving successful claims submissions and identifying the root cause of denied claims.

The Medical Billing Specialist must be a driven and commercial individual who is consistently looking for opportunities and performance improvement but without taking undue risk. Competitive and growth orientated, along with being tenacious, with a high degree of accountability. This is a highly compelling career opportunity for a Medical Billing Specialist to join a business that is revolutionising the perinatal education space in the US.

KEY RESPONSIBILITIES

• Analyze and Address Denied Claims: Monitor and investigate denied claims, identifying and addressing root causes.
• Accounts Receivable Posting: Accurately post accounts receivable transactions.
• Unpaid Claims Investigation: Investigate and report on trends related to unpaid claims.
• Innovative Problem Solving: Develop and implement innovative solutions to billing issues.
• Insurance Compliance: Interpret insurance guidelines, fee schedules, and contracts to ensure compliance.
• Correspondence Management: Respond promptly to incoming correspondence.
• Provider Credentialing Updates: Update and maintain provider credentialing information.
• Metrics Maintenance: Track and maintain individual performance metrics.
• Customer Service Support: Assist the customer service team with incoming billing department calls, as needed.
• Regulatory Compliance: Maintain knowledge of and compliance with relevant laws, regulations, and policies; compliance is a condition of employment and is considered an element of job performance.
• HIPAA/Patient Confidentiality: Ensure the confidentiality of patient information in compliance with HIPAA regulations.
• Additional Duties: Perform other duties as required.

PROFESSIONAL BUSINESS EXPERIENCE

• Experience: Minimum of 1+ year of medical billing experience.
• Education: High school diploma or GED or other relevant professional qualification
• Medical Terminology: Proficient in medical terminology and coding systems (e.g., ICD-10, CPT).
• HIPAA Compliance: Thorough understanding of HIPAA regulations and patient confidentiality standards.
• Software Proficiency: Experience with medical billing software and electronic health records (EHR) systems.

CHARACTERISTICS FOR SUCCESS

• Detail-Oriented: Meticulous attention to detail to ensure accuracy in all billing and coding activities.
• Analytical Thinking: Ability to analyze complex billing issues and develop effective solutions.
• Integrity: Strong ethical standards and commitment to maintaining patient confidentiality and compliance with regulations.
• Problem-Solving: Resourceful and proactive in identifying issues and implementing solutions.
• Adaptability: Flexible and able to adapt to changes in regulations, processes, and technology.
• Continuous Learner: Willingness to stay updated on industry changes and continuously improve knowledge and skills, and most importantly, to be willing to learn from others.
• Technologically Proficient: Comfortable using various medical billing software, EHR systems, and other technology tools.