Medical Biller
2 weeks ago
We are looking for an experienced medical biller /AR specialist for a specialty surgery group full-time in Odenton, MD. Must have experience working directly for a private practice, not a hospital or billing company, doing billing, coding, charge entry and AR work only. Though training will be provided, we are looking for a team member who is not afraid to tackle multiple projects at the same time and dive right into the coding and billing work quickly. This individual needs to have integrity, be motivated, and organized, pay extra attention to detail, be proactive with work and ways to improve workflow and operations, and be a team player - willing to help other staff when needed but also can work independently with minimal supervision. This is an in-office position with no remote work, so the incoming candidate must be willing to work full time in our office in Odenton.
About us:
We are a highly reputable team of medical doctors, compassionate providers/colleagues and support staff and we work hard to help our patients live a pain-free, active lifestyle. We have helped thousands of individuals in the community of Odenton, as well as the surrounding areas. Our philosophy is that everyone deserves a fair chance to enjoy and participate in the things they love, and we are committed to education and research to provide numerous effective treatment options for our patients in need. We have a dynamic, friendly, and compassionate team and we enjoy working together in our welcoming team environment.
Primary Responsibilities:
- Responsible for obtaining authorization for pain management procedures from insurance companies.
- Responsible for Billing and Coding, Pre Certification and Credentialing
- Responsible for collecting, outstanding account payments.
- Responsible for following up with insurance companies and patient accounts.
- Proficient w/ government and commercial Understanding of insurance websites and form fields for authorization submission
- Maintain up to date information on various insurance companies and any relevant changes
- Keeps management informed of changes or issues
- Completes other tasks or responsibilities as assigned
- Responsible to reduce aged A/R.
- Analyze Explanation of Benefits (EOB’s) and Correspondence to identify zero pays and underpayments.
- Responsible to follow-up with healthcare insurance companies on outstanding medical claims and appeals.
- Maintain open communication with the insurance verification team, billing department and office support staff.
- Conduct collection actions and provide resolution for complex accounts.
- Provide supporting documentation that supports collection actions.
- This position is responsible for obtaining and completing all insurance pre-certifications and authorizations as required for various clinical procedures.
- Determines necessity for pre-certification and coordinates with insurance companies, patients and clinical staff to obtain information.
- Maintains complete and accurate documentation in patient charts.
- Develops and maintains effective relations with insurance companies, physicians and medical office staff.
- Must have proficient knowledge of insurance requirements, medical/clinical terminology, medical necessity associated with various clinical procedure codes and certification/referral work flow.
- Monitor new patient report and maintain organized list with status of pre-certification process.
- Verify insurance eligibility and benefits via phone and/or internet access. Update insurance policy information.
- Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
- Verify receipt of all necessary pre-authorization documents prior to procedure
- Communicate effectively with the facility in which the procedure will be performed as needed.
- Assign appropriate ICD and CPT codes pre-operatively based on documentation and booking slips.
- Notify primary care physician for managed care plans that require PCP authorization.
- Serve as a resource on insurance, billing and customer service for reception.
- Has knowledge of commonly used concepts, practices, and procedures within the Medical Billing and Medical Insurance field
- Works independently with minimal supervision, detail oriented and organized
- Complete multiple tasks simultaneously
- Must have experience working directly for a private practice, not a hospital or billing company, doing billing, coding, charge entry and AR work only.
- Must be willing to work full time in our office in Odenton.
- $23 per hour
- Health insurance
- Dental and Vision insurance
- PTO
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