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Medical Billing Specialist

2 months ago

Somerset NJ United States SpineSearch Full time
Spine Search is seeking an experienced Billing Specialist to join a leading pain management practice in Somerset, NJ. This is a full time, Monday-Friday position offering comprehensive benefits.

*JOB DESCRIPTION: *Follows up on rejected claims and overdue patient and insurance balances using Explanation of Benefits forms and reports. Builds and maintains relationships with specified payors. Manages patient A/R, statement processing, and considers accounts for outside collections.

*Responsibilities and Duties*

*Account Follow Up*
* Works with patients, following up on outstanding statements.
* Using data from the monthly aged accounts receivable report, calls payors or looks up claims status online to inquire about unpaid insurance claims that are 45 days old; records response or activity in the computer system "notes"
* Makes necessary arrangements for medical records requests, completion of additional paperwork, etc., if payors request this information prior to payment of claims
* Uses payor policy manuals (often found online) to support completion of assigned tasks
* Responds to written and telephone inquiries from insurance companies
* Manages relationships with personnel from assigned carriers
* Meets with Office Manager regularly to discuss and solve reimbursement and insurance follow up problems
* Calls carriers to appeal payments that do not match contractual agreement; notifies Office Manager of payors for which this is a consistent problem
* Asks physician to provide appeal language for denials or unacceptable payment
* Processes requests for insurance refunds, and submits to Office Manager for approval
* Responds to written and telephone inquiries from patients regarding their insurance questions

*Claims Filing*
* Processes all paper and electronic claims for assigned carriers—verifies completeness of paper insurance claim information before mailing
* Reviews edit reports from clearinghouse daily and resolves issues so claims can be processed
* Follows up on rejected claims the day that the rejected EOB is received

*Qualifications and Skills*
* Minimum eighteen months experience working in a physician group practice billing department
* Familiar with CPT and ICD-10-CM coding for _orthopedic surgery, podiatric_ _surgery, and pain management procedures._
* Familiarity with both facility (ASC/Hospital) billing and professional (Office) billing
* Comfortable using email and interacting with Internet applications
* Knowledge of practice management and word processing software
* Able to establish good relationships with insurance companies
* Good analytical skills and an affinity for detail
* Ability to read and analyze accounts receivable and payor reports
* Pleasant speaking voice and demeanor
* Neat, professional appearance
* Strong written and verbal communication skills
* Accurate and fast data entry skills
* Bilingual (Spanish) candidates preferred, but will consider others with solid experience

Experience:
* Insurance Billing & Collections: 2 years (Required)
* Patient Billing & Collections: 1 year (Required)
* Ambulatory Surgical Center Billing & Collections: 2 years (Preferred)

#INDLP

Job Type: Full-time

Pay: $23.00 - $26.00 per hour

Benefits:
* 401(k)
* Dental insurance
* Health insurance
* Paid time off
* Vision insurance
Schedule:
* Monday to Friday

Experience:
* Medical billing: 2 years (Preferred)

Language:
* Spanish (Preferred)

Work Location: In person