Billing Specialist

2 months ago

Portland, United States Martin's Point Health Care Full time

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

Position Summary

**Job Description**:
- Position Summary:
Key Outcomes:
- Prioritize workload to align with department metrics and goals
- Follow our current AR aging workflow in order to minimize loss of revenue for the delivery system
- Answer incoming patient calls and address patient issues and concerns in a timely manner
- Research and resolve insurance overpayments
- Research and process patient credit balances
- Work with individual payers to resolve issues affecting claims processing
- Process and respond when needed to patient and payer correspondence
- Act as a resource to the sites which are assigned, including occasionally traveling to the site to help with PSR education and training
- Assist patients with issues related to accounts in collections and accounts from legacy systems
- Research & resolve balances that are unable to be applied against a patient’s account by athena
- Appeal denials and send corrected claims to payers
- Correctly classify payer Incentive Payments according to appropriate MPHC contracts
- Maintain positive relationships through communication and commitment to the team and their work
- Learn new workflows and demonstrate flexibility when needed to help other teams or work on special projects identified by management
- Work closely with the coding team to maximize revenue and decrease the number of rejected claims
- Education/Experience:
- High School Diploma or GED
- 2+ years clerical or related experience
- Data Entry experience
- Primary care claims experience preferred
- Knowledge of medical terminology, ICD-9 & ICD-10, CPT and HCPCS coding preferred
- Must be proficient in use of computers, terminals and keyboards
- Experience with MS Office products preferred
- Skills/Knowledge/competencies:
- Demonstrates an understanding of and alignment with Martin’s Point Values.
- Ability to maintain confidentiality of healthcare data (HIPAA Compliance)
- Capacity to be cross trained to new payer types as business indicates
- Demonstrates significant change agility
- Ability to demonstrate MPHC Core Competencies
- Team player
- Excellent organizational skills and attention to detail- ID- ID- 10143We are an equal opportunity/affirmative action employer.

Do you have a question about careers at Martin’s Point Health Care? Contact us at:

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