Medical Billing Specialist
2 days ago
We are seeking a highly skilled and detail-oriented Medical Billing/AR Specialist to join our team at Sutherland. As a Medical Billing/AR Specialist, you will play a critical role in ensuring timely and accurate payment collection activity.
Key Responsibilities:
- Conduct collection activity on appealed claims by contacting government agencies, third-party payers via phone, email, or online.
- Provide ongoing appropriate collection activity on appeals.
- Request additional information from patients, medical records, and others as needed.
- Communicate with insurance plans and research health plans for benefits and types of coverage.
- Review contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed.
- Handle other duties as assigned.
Requirements:
- Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies.
- Full understanding of Managed Care collections.
- Familiarity with terms such as MMC, HMO, PPO, IPA, and Capitation and how these payers process claims.
- Knowledge of Managed Care contracts, Contract Language, and Federal and State requirements.
- Intermediate understanding of Hospital billing form requirements (UB04) and HCFA 1500.
- Medical claims and/or hospital collections experience.
- Minimum high school education, technical training, and/or other related experience.
Requirements for Remote Work:
- Excellent Internet connectivity: Internet access speeds of at least 5 Mbps upload and 30 Mbps download – the faster the better.
- In-house network, and a hard-wired Internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (Wireless and/or satellite Internet Service Providers are not compatible with our systems).
- A quiet and distraction-free, secure place to work.
Important Note:
This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.
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