Medicare/medicaid Billing Specialist

7 days ago


Houston, United States AAMA- Association for the Advancement of Mexican Americans Full time

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to join our amazing team
- Perform posting charges
- Perform completion of claims to payers
- Conduct duties in a professional and timely fashion
- Submit billing data to the appropriate insurance providers primarily Medicare, Medicaid
- Process claims
- Resolve denial instances
- Achieve maximum reimbursement for services provided
- Deploy, maintain, and report on various programs
- Do Medicare and other insurance reviews
- Conduct audits *Credentialing/Enrolling:*
- Review and process counselors and therapist initial supporting documentation.
- Follow up with counselors and therapists to ensure all information is obtained.
- Ensure that re-credentialing is complete and timely to prevent any lapse in enrollment.
- Maintain confidentiality of all counselor and therapist information
- Enroll OTP in Medicare/Medicaid Advantage plans *Billing:*
- Verify coverage and eligibility for substance use disorder services and medication services
- Post charges and payments to correct accounts
- Communicate with insurance providers, counselors, therapists, and clients
- Review client bills and correct any missing or inaccurate information
- Use of insurance carrier portals for eligibility and claims information
- Investigate and appeal claims that were denied
- Complete data entry to update spreadsheets and reports
- Work with clients to set up payment plans *Soft Skills:*
- Interact virtually with clients
- Creative problem-solving skills
- Work independently
- Collaborate well with others
- Multitask *Qualifications*
- Effective communication skills
- Interact virtually with clients and patients
- Creative problem-solving skills
- Work independently
- Collaborate well with others
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
- Competent use of computer systems, software, and EHRs
- Familiarity with CPT Coding
- Experience with behavioral health billing
- Experience with behavioral health credentialing
- Exceptional Customer Service skills for interacting with clients regarding medical claims and payments, including communication with patients and family members
- Ability to work well in a team environment
- Ability to triage priorities and handle conflict in a reasonable fashion
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
- Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Ability to multitask
- At least 2-3 years of recent medical billing experience
- Able to pass a Drug Test
- Associate's degree or higher
- Minimum of 3 years experience in medical billing or any coding industry
- Proficient in electronic medical records Pay: $18.00 - $21.00 per hour Benefits:

- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance Schedule:

- 8 hour shift
- Monday to Friday Experience:

- Medicaid/Medicare Billing: 2 years (required) Work Location: In person



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