Billing/Scheduler

2 weeks ago

Alpharetta, United States SPCPSoutheast Medical Group Full time
Job DescriptionJob DescriptionDescription:

This position is expected to have excellent reasoning skills based on knowledge of clinic operations as it pertains to billing claims to Insurance Health Plans, coding for medical diagnosis and procedural coding. Individual must be familiar with the conventions and instructions provided within the ICD disease classifications and CPT coding guidelines. Should also be able to reason through insurance claims differences as defined by benefit and plan differences. This position is responsible for resolution of A/R in a complete, accurate, and timely manner while verifying that industry rules and regulations, including, local, state, and federal regulations, regarding billing and collection practices are followed; as well as with established internal policy and procedure.

Requirements:
  • Review medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed.
  • Verifies appropriate CPT, ICD, and HCPCS codes to accurately file claims for the physician service using the medical record as supporting documentation.
  • Performs corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information.
  • Responsible for working EDI claim rejections in a timely manner.
  • Receives and interprets Explanation of Benefits (EOB) that supports payments from Insurance Carriers, Medicare, or patients. Able to apply correctly to claims/ fee billed.
  • Processes incoming EOBs to ensure timely insurance filing or patient billing. May require correction of data originally submitted for a claim or Coordination of Benefits with secondary insurance.
  • Responsible for processing payments, adjustments and denials according to established guidelines.
  • Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts.
  • Responsible for reporting payer payment and denial trends in a timely fashion.
  • Responsible for reconciling transactions to ensure that payments are balanced.
  • Responsible for reducing accounts receivables by accurately and thoroughly working assigned accounts in accordance with established policy and procedures.
  • Responsible for keeping current with changes in their respective payer’s policies and procedures.
  • Communicates with the Clinics to provide or obtain corrected or additional data.
  • Able to prepare documents for training or for establishing procedures for clinics.
  • Identifies problems and root cause of problems related to billing and collections.
  • Assist with training materials and training staff members.
  • Responsible for identifying problems/trends in medical documentation and reporting them in a timely fashion.
  • Answers patient and customer questions regarding billing and statements.
  • Prepare claims for encounters with complex progress note issues.
  • Participates in special assigned projects.

Minimum Required Education, Experience & Skills

  • High school diploma or GED equivalent
  • Strong attention to detail and professional customer service skills
  • Proficiency with Microsoft Office applications

Preferred Education, Experience & Skills

  • Two years of relevant medical experience; medical terminology and ICD/CPT coding preferred.
  • Technical skills in the areas of EDI, systems analysis and process flows required.
  • One or more years of related billing and/or collection experience required.
  • Coding certification preferred but not required.
  • 50wpm typing skill preferred.
  • Knowledge of submission and resubmission of medical claims.
  • Knowledge of government and commercial policies and procedures.
  • Knowledge of ICD, CPT codes and HCPCS coding.
  • Knowledge of HIPAA compliance rules and regulations.
  • Skill in the operation of billing software and office equipment.

Physical & Mental Requirements:

  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving
  • Ability to travel to multiple locations to support business needs as required

  • Medical Billing

    4 weeks ago

    Alpharetta, United States Urogynecology PC Full time

    Job DescriptionJob DescriptionMiklos and Moore Urogynecology is looking for a Receptionist to join our team in our Alpharetta office. The ideal candidate will deliver a professional and qualified first impression to all visitors. This person has excellent communication and customer service skills. He/she has a basic understanding of administrative and...

  • Medical Billing

    3 weeks ago

    Alpharetta, United States Urogynecology PC Full time

    Job DescriptionJob DescriptionMiklos and Moore Urogynecology is looking for a Receptionist to join our team in our Alpharetta office. The ideal candidate will deliver a professional and qualified first impression to all visitors. This person has excellent communication and customer service skills. He/she has a basic understanding of administrative and...

  • Staff Accountant

    1 week ago

    Alpharetta, United States ABM Full time

    ABM is seeking a highly motivated and detail-oriented Mid-Level Accountant to join our finance team. The Mid-Level Accountant will play a key role in managing and maintaining financial records, preparing financial reports, and supporting various accounting functions. The successful candidate will contribute to the overall financial health and success of ABM...

  • Staff Accountant

    4 weeks ago

    Alpharetta, United States ABM Industries Full time

    Overview ABM is seeking a highly motivated and detail-oriented Mid-Level Accountant to join our finance team. The Mid-Level Accountant will play a key role in managing and maintaining financial records, preparing financial reports, and supporting various accounting functions. The successful candidate will contribute to the overall financial health and...

  • Product Marketing Manager, Sr at Fiserv in Alpharetta, GA

    3 weeks ago

    Alpharetta, United States Fiserv Full time

    Bachelor's degree in marketing or business field Minimum 5-7 years marketing experience in large product marketing organization or agency experience Experience with Pragmatic Marketing Strong leadership, communication, and organizational skills with the flexibility to shift priority projects as required Excellent written and verbal communications including...

  • Lead Mechanical Engineer

    2 weeks ago

    Alpharetta, United States Selectek Full time

    Immediate opening for a lead mechanical opening in Atlanta, GA. Summary: A Lead Mechanical Engineer to be responsible for creating new designs based on customers’ scheduled and budget requests that meet the contract requirements, customer expectations, and company standards and practices. Lead and supervise all mechanical design aspects of a...

  • Network Engineer

    2 weeks ago

    Alpharetta, United States Fluence Full time

    The Network Engineer is responsible for the following duties: [Install, configure and maintain cost-effective networks for next-generation battery energy storage systems (BESS), power integration and solutions. Provide innovative system design, controls, monitoring and network solutions. Take initial network design concept ideas and turn them into fully...

  • Lead Mechanical Engineer

    3 weeks ago

    Alpharetta, United States Selectek Full time

    A Lead Mechanical Engineer to be responsible for creating new designs based on customers’ scheduled and budget requests that meet the contract requirements, customer expectations, and company standards and practices. Lead and supervise all mechanical design aspects of a project with external customers, internal customers, and design resources.Required:...

  • Account Specialist

    1 week ago

    Alpharetta, United States EPIC Insurance Brokers & Consultants Full time

    Job Summary The Account Specialist’s main responsibilities include: Support Broker with providing client service Produce/assist with producing client submissions, proposals, presentations, insurance summaries and reports Coordinate and review billing, invoice materials, and premium finance agreements Create and update account information in shared...

  • Revenue Accountant

    3 weeks ago

    Alpharetta, United States PlayOn Sports Full time

    COMPANY OVERVIEW The future of high school athletics and activities is powered by PlayOn! Sports. Through GoFan, the NFHS Network, and rSchoolToday, the PlayOn team elevates the event experience for schools and communities across digital ticketing, fundraising, concessions, streaming, websites, and activity management. PlayOn has united top brands in the...

  • Program Coordinator

    22 hours ago

    Alpharetta, United States HRC International Full time

    Company DescriptionHRC International is a training and career development company based in Alpharetta, GA. Since 1995, HRC has been connecting the best possible employers with the best possible employees in the international hospitality and education industry. As a designated J-1 visa sponsor, HRC provides qualified hospitality talents at luxury hotels and...

  • Program Coordinator

    18 hours ago

    Alpharetta, United States HRC International Full time

    Company DescriptionHRC International is a training and career development company based in Alpharetta, GA. Since 1995, HRC has been connecting the best possible employers with the best possible employees in the international hospitality and education industry. As a designated J-1 visa sponsor, HRC provides qualified hospitality talents at luxury hotels and...

  • Program Coordinator

    1 day ago

    Alpharetta, United States HRC International Full time

    Company DescriptionHRC International is a training and career development company based in Alpharetta, GA. Since 1995, HRC has been connecting the best possible employers with the best possible employees in the international hospitality and education industry. As a designated J-1 visa sponsor, HRC provides qualified hospitality talents at luxury hotels and...

  • Claims Adjuster II

    2 weeks ago

    Alpharetta, Georgia, United States AmTrust Financial Services, Inc. Full time

    Overview: AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Claims Adjuster II - WC. The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures,...

  • Claims Adjuster I

    2 weeks ago

    Alpharetta, Georgia, United States AmTrust Financial Services, Inc. Full time

    Overview: AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Claims Adjuster I. The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and...

  • Plumbing-Piping-Formen-Superintendents-Apprentices-Helpers

    4 weeks ago

    Alpharetta, United States Tebarco Mechanical, LLC Full time

    Job DescriptionJob DescriptionHours/Schedule: Full-time opportunity, Monday-Friday hours required to maintain project success, must be flexible to extended hours as neededWork environment: Onsite, various locationsWho we are: Tebarco is a full service, licensed mechanical contractor & engineering firm. We provide complete design and installation of site...