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Medical Biller Collections Representative

2 months ago

Costa Mesa, United States DME Medical Device Manufacturer Retailer Full time
Job DescriptionJob Description

Please do not apply if you are seeking a remote or hybrid role, this is an On-Site position only.

Summary: Our company is a DME Medical Device Manufacturer-Retailer. The Medical Billing and Collections Specialist is a key team member responsible for advanced computerized billing and electronic claim submission functions and collections  This role involves handling difficult, demanding, and complex tasks, requiring specialized knowledge to modify existing methods, solve problems, and complete tasks, especially in the context of collections. Work is typically performed under general direction.

Essential Duties and Responsibilities:

  •  Biller responsible for all electronic billing to insurance carriers as required by contract or industry standards.
  • Inform members of other departments about discrepancies in patient accounts, data entry errors, accounts receivable issues, inventory issues, and follow-up issues. Resolve issues in a timely manner to facilitate billing completion.
  • Follow the order through to completion by validating the receipt of appropriate paperwork, including prescriptions, delivery tickets, orientation checklists, and chart establishment.
  • Appropriately bill for the products/services received by the patient per Company policy and procedure.
  • Re-bill or bill for purchased products/services re-rented by the patient, consistent with Company policy and procedure.
  • Routinely review billing status reports to maintain current billing and identify discrepancies/omissions.

Collections:

  • Proactively pursue and resolve denied, non-payment or short-paid claims.
  • Conduct intensive research to resolve denied or short-paid claims and manage outstanding accounts.
  • *Develop proactive problem-solving methods related to departmental processes, Company processes, and/or database software.
  • Provide or recommend solutions to a variety of problems.
  • Provide general guidance and training to other non-exempt staff and team members.
  • Act as a liaison between departmental management and subordinate non-exempt team members on issues regarding departmental procedures, concerns, or recommendations for improvement.
  • Maintain advanced knowledge of paper and computer systems related to departmental systems and hardware/software utilization.
  • Maintain general knowledge of VQ OrthoCare product line.
  • Maintain specialized knowledge of billing and electronic submission practices, procedures, and policies.
  • Maintain specialized knowledge of Medicare and familiarity with group insurance and workers’ compensations practices.
  • Maintain familiarity with HIPAA regulations related to maintaining confidentiality of patient information.
  • Apply basic billing concepts to business actions and reporting.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions.

 

Education/Experience:

  • 2+ years related experience or equivalent of education plus directly related education, training and experience.
  • 2+ years prior experience with MediCare billing and collections-Preferred
  • Strong Attention to Detail

Physical and Mental Demands:

  • Typically interacts with staff, peers, senior management and external customers
  • Ability to handle moderate to high stress
  • Regularly required to sit, stand, move about, stoop, bend, reach, finger and grasp and to move and/or lift up to 50 pounds
  • Regularly must see and read computer displays and reports, PDA displays & cell phone displays
  • Must regularly type and or enter data using computer keyboards.

 

Certificates and Licenses:

  • No special certificates, licenses or registrations are required

Supervisory Responsibilities:

The job has no supervisory responsibilities.

 

Work Environment:

Reasonable accommodations may be provided in order to allow qualified individuals with disabilities to perform the essential duties and tasks.

The work environment varies between that of a typical office setting with controlled temperature and humidity and a typical automobile interior, traffic and noise associated with commuting, along with typical patient home environments for short durations. Ambient noise levels are consistent and generally low to moderate.

Company is an Equal Opportunity Employer: All Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Company is a participating E-Verify employer

 

Company DescriptionDME Medical Device Manufacturer RetailerCompany DescriptionDME Medical Device Manufacturer Retailer