Medical Billing Specialist
2 weeks ago
Responsibilities
- Processing insurance claims through both private insurance and Medicare
- Process insurance denials and appeals to ensure timely account resolution
- Identify denial trends and determine process changes to prevent future denials
- Work with Medical Coders to address editing coding and payment related issues
- Enter all billing and payment information into the system properly and without errors
- Responsible for lowering AR over 90 days to acceptable standards
- Answer phones, assist clients with questions, take messages, and screen calls
- Handle incoming calls from patients and insurance companies regarding claims and patient balances
- Maintains the highest level of confidentiality.
- Supports and adheres to all policies and procedures.
- Review accounts that have partial or under payments
- Work with supervisors to streamline billing procedures based on denial types
- Post contractual adjustments and transfer deductibles to patient accounts based of correspondence from the insurance carriers
- Daily follow up on all claim reports generated based on rejections, appeals and denials by the insurance carrier
- Uphold confidentiality and security standards by adhering to professional guidelines, company policies, and federal, state, and local requirements
EClinical works experience a must
3 years' experience in healthcare collections setting
In-depth knowledge of CPT and ICD-10 codes, Medicare and commercial billing rules, insurance reimbursement methods, claims
appeal process, managed care contracts, and payments
Ability to read explanation of benefits (EOBs) is critical for this position
Strong cognitive skills including analysis, problem solving, high attention to detail, and decision making
Ability to work collaboratively with other team members to support data quality and integrity initiatives
Great organizational skills
Ability to work on multiple assignments concurrently within established timeframes
Ability to multi-task, establish and meet deadlines
Ability to work in fast-paced environment and maintain accuracy
Strong verbal and written communication skills
Ability to troubleshoot and recommend root cause solutions to problems
Above average organizational and time management skills
Strong Microsoft Office experience with emphasis on Excel (intermediate to advanced)
Knowledge of Federal, state and HIPAA privacy regulations
High School graduate or equivalent
Benefits
Health insurance
Vision insurance
Dental insurance
Life insurance
Vacation
Competitive Compensation
Great Work Environment
Career Advancement Opportunities
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