Medical Billing Specialist

3 days ago


New York, New York, United States CAIPA MSO LLC Full time
Job Summary

CAIPA MSO LLC is seeking a highly skilled Medical Billing Specialist to join our team. As a key member of our healthcare revenue cycle team, you will be responsible for ensuring accurate and timely payment of claims and collection.

Key Responsibilities
  • Verify insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries
  • Review encounter forms for accuracy and obtain pre-certification for scheduled surgeries and admissions
  • Enter office, inpatient, and/or outpatient charges with accurate data entry of codes
  • Post payments / adjustments from paper EOBs and ERAs using approved methodologies with strong reconciliation skills
  • Perform specialty coding for services and medical office visits and review physician coding and provide updates to physicians and staff
  • Work system edits and clearinghouse rejections and proficient in moderate to complex encounters and problematic accounts
  • Work daily Accounts Receivable accounts via online workfile and/or hard-copy reports; check claim statuses, re-submit claims, edits, denials and process appeals
  • Research unidentified / missing checks and communicate with appropriate parties for replacements
  • Work credit balance report to ensure adherence to government regulations/guidelines
  • Analyze claims system reports to ensure underpayments are correctly identified and collected from key carriers
  • Review and resolve billing issues and provide recommendations
  • Identify and assist in resolving credentialing issues
  • Mentor less experienced Billing staff and assist Billing Manager/FPA Manager in training new staff
  • May be responsible for collection of time-of-service payments, and maintaining daily transaction record of collected payments
Requirements
  • Associates Degree or high school diploma/GED plus 3 years of relevant experience
  • CPC Preferred
  • Trained in computerized medical billing
  • 3 years' experience in medical billing or health claims in a health care or insurance environment, and familiarity with ICD/CPT coding
Benefits
  • Health Benefits: Medical, Vision and Dental
  • 401k retirement plan
  • Paid Time Off
  • Hybrid Work Model
Salary Range:
  • $40,000 - $60,000


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