Medical Billing Specialist

3 weeks ago

Nashville, United States Upperline Health Full time
Job DescriptionJob Description


ABOUT US

A Specialty Path to Good Health

Upperline Health is the nation’s largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care, Upperline Health delivers a more efficient path for patients to receive consistent and effective treatment for chronic illnesses.

Triage is temporary.

Treatment is transformative.

Upperline Health providers coordinate patients’ care among a team of specialists – physicians, advanced practice providers, care navigators, pharmacists, dieticians, and social workers for integrated treatment that addresses patients’ immediate and long-term health needs.

We put patients at the center of value-based care.

This is a remote position with preference for candidates in EST or CST. The position is available to candidates who currently reside in the following states: AL, CA, FL, GA, IL, IN, KY, MI, NC, NV, PA, TN, TX.

About the Medical Billing Specialist
Upperline Health is looking for a Medical Billing Specialist to work within our revenue cycle function to be responsible for medical A/R and claims management for 8 to 10 of our physicians. The Medical Biller will have a diverse set of revenue cycle responsibilities including appealing claim denials, working claim holds, monitoring staff claim submission, overseeing the reconciliation of time-of-service collections, and maintaining acceptable A/R aging. Upperline's medical billers must have effective communication skills as they are in a collaborative position working with revenue cycle managers, clinic staff members, patients, insurance representatives, and physicians. This individual needs to be a self-motivated, problem-solver, and able to multi-task effectively in a fast-paced environment. As Upperline continues to rapidly grow, this position presents a range of future career growth opportunities. 

What You’ll Do

  • Maintain A/R aging balances within revenue cycle department standards for assigned 8-10 physicians.
  • Effectively and efficiently work a minimum of 60 claims per day.
  • Draft and send claim appeal letters with a high success rate.
  • Answer patient and/or staff questions regarding billing issues.
  • Identify suboptimal patterns in physician and/or staff revenue cycle behaviors.
  • Collaborate with physicians on clinical documentation, code selection, and other relevant issues.
  • Collaborate with clinic staff regarding charge posting, referrals, authorizations, and insurance verification.
  • Oversee accurate reconciliation of time-of-service collections and execution of the processes that are compliant with the revenue cycle department’s standards.
  • Review and send patient accounts to outside collections partner.
  • Review and validate patient refund requests.
  • Assist with insurance authorizations and verification of benefits.

Qualifications of the Medical Billing Specialist:

  • Minimum of 1-2 years of medical billing, coding, and collections experience is preferred.
  • Open to training motivated, entry level or new graduates of medical billing programs.
  • Podiatry or Ortho experience is a plus.
  • Current knowledge of coding, billing and reimbursement for commercial insurance, Medicaid, and Medicare.
  • Thorough understanding of EOBs, patient billing summaries, and other similar documents.
  • Ability to read clinical documents to confirm accurate coding.
  • Effective communication skills, both written and verbal.
  • Previous electronic medical records (EMR) system experience, preferably athenahealth.
  • Proficient in Excel.
  • Desire and ability to comply to department’s best practices and hit daily, weekly, and monthly targets.
  • Strong time management and critical thinking skills.


BENEFITS

Comprehensive benefit options include medical, dental and vision, 401(k), and PTO.

COMPENSATION

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience.

Job Type: Full-Time

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