Healthcare Billing and Collections Specialist

2 weeks ago


Englewood, New Jersey, United States Progressive Spine & Orthopaedics, LLC Full time
Position Overview:

The Healthcare Billing and Collections Specialist is essential in ensuring that healthcare providers receive appropriate compensation for the services rendered to patients.

Key Responsibilities:
  • Accurately process healthcare claims and code medical procedures.
  • Input information into the billing system and submit claims to insurance providers.
  • Generate and electronically submit claims and statements at scheduled intervals, ensuring timely processing.
  • Monitor the status of submitted claims and follow up with insurance companies to address discrepancies or denials.
  • Record payments from insurance companies, patients, or other sources, applying them to the correct accounts while maintaining balance sheets.
  • Assign appropriate medical codes (e.g., ICD-10, CPT) to diagnoses, treatments, procedures, and surgeries.
  • Prepare and review medical claims for accuracy, completeness, and compliance with regulations.
  • Respond to patient inquiries regarding billing and insurance, explaining charges and assisting in resolving disputes.
  • Stay informed about changes in healthcare regulations, insurance policies, and coding guidelines.
  • Maintain organized records of all billing and claims-related activities.
  • Generate reports to track billing and collections performance, including accounts receivable aging reports.
  • Prepare correspondence and collection letters as necessary.
  • Draft appeal letters to insurance companies for denied claims, submitting necessary documentation to support claims.
  • Perform additional duties such as copying checks received, faxing information, generating retroactive authorization requests, and verifying medical eligibility.
Qualifications:

Preferred candidates will possess a degree or certification in medical billing or a related field. Strong experience in NJ OON Orthopedics collections is required. Knowledge of medical terminology, anatomy, and coding systems (ICD-10, CPT) is essential. Proficiency in medical billing software and electronic health record (EHR) systems is necessary, along with an understanding of healthcare billing regulations and compliance standards. Strong problem-solving skills are required to resolve billing discrepancies and denials, and the ability to manage multiple projects and meet deadlines is crucial.

Benefits:
  • Health, dental, and vision insurance
  • Retirement Plan
  • Employee Assistance Program
  • Standard work schedule (Monday to Friday, no weekends)

Job Type: Full-Time (8-hour shifts)

All qualified applicants will be considered for employment regardless of age, national origin, race, color, disability, religious beliefs, or sexual orientation.



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