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Billing Specialist
4 months ago
Developmental Pathways is seeking an experienced Medical Biller with experience in ABA services to work in our administrative office. The ideal candidate will have a strong background in medical billing, with the skills necessary to improve our current billing procedures and reduce A/R days. The successful applicant will work on a number of tasks requiring data analysis, in-depth evaluation and exercising judgement within the appropriate scope of practice. We offer excellent benefits, generous paid time off and competitive compensation.
Responsibilities:
· Audits and corrects all claims on UB04 and/or CMS 1500 format.
· Review all EOB’s received in the mail that require attention.
· Complete data entry of all patient demographics, guarantor, and insurance information.
· Post procedures and insurance.
· Manage relationships with various Insurance payers.
· Call insurance companies to resolve billing issues.
· Call for Verification of Benefits.
· File claims to ensure maximum entitled reimbursement.
· Follow orders of detailed work activity.
· Ensure all claims are submitted with a goal of zero errors.
· Verify completeness and accuracy of all claims prior to submission.
· Meet all deadlines given.
· Read and interpret insurance explanation of benefits.
· Respond to inquiries from insurance companies, patients, and providers.
· Regularly meet with Financial Manager to discuss and resolve reimbursement issues or billing obstacles.
· Attend monthly staff meetings and continuing educational sessions as requested.
· Perform additional duties as requested by Director or Management team.
· Obtaining referrals and pre-authorizations as required for procedures.
· Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
· Following up on unpaid claims within standard billing cycle timeframe.
· Checking each insurance payment for accuracy and compliance with contract discount.
· Calling insurance companies regarding any discrepancy in payments if necessary
· Identifying and billing secondary or tertiary insurances.
· Researching and appealing denied claims.
· Setting up patient payment plans and work collection accounts.
· Updating billing software with rate changes.
· Updating cash spreadsheets and running collection reports.
Qualifications:
· High School Diploma/GED required.
· Minimum 2 years’ experience as a Medical Biller.
· Experience in ABA service codes required.
· Experience with NPA codemetro and Office Ally.
· Proficiency with electronic medical records (EMR)
· Strong knowledge of MS Access
· Ability to work independently and collaboratively within a team environment
· Able to multi-task and meet tight deadlines
· Excellent problem-solving skills
License:
· Driver's License (Required)
Typical start time:
· 9AM
Typical end time:
· 6PM
Pay Frequency:
· Bi weekly or Twice monthly
Pay:
· Hourly: $18 to $23 (upon knowledge and experience)
Schedule:
· Monday to Friday
· Day shift
Company's website:
· www.dpica.com
Work Remotely:
· No