Billing Specialist
2 weeks ago
AllCare Primary and Immediate Care has grown into a trusted provider of comprehensive healthcare services with over 30 locations across Maryland, Virginia, Washington DC, and Georgia. We are committed to continuous expansion and are proud to bring convenient access to high-quality primary care to communities in need. We are hiring two Billing Specialists, Revenue Cycle to join our team
The Billing Specialist is responsible for assisting with the coding/billing operations for AllCare. The essential functions include accurate and timely code selection and charge submission for all professional billable services. The Billing Specialist helps manage insurance claims and payments. The day-to-day work of the billing specialist includes properly coding services, procedures, diagnoses, and treatments and preparing and sending claims for payment. This position will report to our Billing Manager.
Responsibilities:
- Has a contagious and positive work ethic, inspires others, and models AllCare values.
- Demonstrates effective verbal and written communication that is clear, well-organized, and demonstrates an understanding of audience needs.
- Adherence to standards of business conduct and compliance.
- Verify coverage and eligibility for medical services.
- Communicate with insurance providers and patients.
- Review patient bills and correct any missing or inaccurate information.
- Assist with timely resolution to billing/claim edits or “holds” in the PM system.
- Use billing software to prepare and transmit claims.
- Responsible for validating coding and billing information required to clear edits.
- Remain current with regulations and coding guidelines regarding new and existing procedures for appropriate code assignment.
- Follow the coding and compliance program as created by the Billing and Reimbursement Coordinator including, controls and compliance measurements consistent with operation policies and documentation.
- Work directly with providers in correcting coding and documentation as needed.
- Accurately capture appropriate coding by reviewing encounter documentation.
- Validate coding and billing information required to clear edits.
- Collect unpaid claims and clear up discrepancies.
- Identifying and billing secondary or tertiary insurances.
- Work with patients to set up payment plans.
- Assists with following up on unpaid claims within standard billing cycle timeframe.
- Assists with payment/remit issues to ensure timely posting of all transactions.
- Assists with patient calls or questions related to billing and self-pay balances.
- Work on special projects, committees, and task forces as assigned.
- Maintain patient, physician, and financial confidentiality.
- Participate in professional development activities and maintain professional affiliations.
- Other duties as assigned.
- Experience with ICD-10 and medical billing - 2 years (Preferred).
- Experience with Athena EMR and PM systems (Preferred).
- Comprehensive understanding and working knowledge of CMS documentation, coding, and compliance regulations and requirements.
- Working knowledge of the HCPCS and ICD coding systems.
- Provider documentation, coding, and charge capture knowledge.
- Knowledge of accepted principles, practices relating to general healthcare professional provider operations.
- Working knowledge of medical terminology and abbreviations and healthcare nomenclatures
- Strong Knowledge of coding and the billing processes.
- Must be able to work with providers to provide guidance on billing.
- Must be computer literate to complete task(s) as required.
- This is a remote role. You must be able to work EST hours and you must be able to provide a secure/HIPAA compliant environment where you will be working.
- Requires?the ability to sit at a computer for hours at a time.
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