Medical Billing Coordinator

2 weeks ago

Lawndale, California, United States DEVELOPMENTAL PATHWAYS INC Full time
Job Overview

Developmental Pathways Inc is in search of a skilled Medical Billing Coordinator with expertise in ABA services to join our administrative team. The ideal candidate will possess a robust background in medical billing, equipped with the capabilities to enhance our existing billing processes and minimize accounts receivable days. The successful candidate will engage in various tasks that necessitate data analysis, thorough evaluation, and exercising judgment within the appropriate scope of practice. We provide excellent benefits, generous paid time off, and competitive remuneration.

Key Responsibilities:
  • Conduct audits and rectify all claims in UB04 and/or CMS 1500 formats.
  • Review all Explanation of Benefits (EOBs) received that require action.
  • Perform data entry for all patient demographics, guarantor, and insurance details.
  • Post procedures and insurance transactions accurately.
  • Manage relationships with diverse insurance payers.
  • Communicate with insurance companies to resolve billing discrepancies.
  • Verify benefits through direct calls.
  • Submit claims to ensure maximum reimbursement eligibility.
  • Adhere to detailed work activity orders.
  • Ensure all claims are submitted aiming for zero errors.
  • Confirm completeness and accuracy of all claims prior to submission.
  • Meet all assigned deadlines consistently.
  • Interpret insurance explanations of benefits effectively.
  • Respond to inquiries from insurance entities, patients, and healthcare providers.
  • Regularly consult with the Financial Manager to address and resolve reimbursement challenges or billing issues.
  • Participate in monthly staff meetings and continuing education sessions as required.
  • Perform additional duties as assigned by the Director or Management team.
  • Obtain referrals and pre-authorizations as necessary for procedures.
  • Prepare, review, and transmit claims utilizing billing software, including both electronic and paper claim processing.
  • Follow up on unpaid claims within the standard billing cycle timeframe.
  • Verify each insurance payment for accuracy and compliance with contractual agreements.
  • Contact insurance companies regarding any payment discrepancies as needed.
  • Identify and bill secondary or tertiary insurances.
  • Research and appeal denied claims effectively.
  • Establish patient payment plans and manage collection accounts.
  • Update billing software with any rate changes.
  • Maintain cash spreadsheets and generate collection reports.
Qualifications:
  • High School Diploma or GED is required.
  • A minimum of 2 years of experience as a Medical Biller is essential.
  • Experience with ABA service codes is required.
  • Familiarity with NPA codemetro and Office Ally is preferred.
  • Proficiency in electronic medical records (EMR) is necessary.
  • Strong knowledge of MS Access is important.
  • Ability to work independently as well as collaboratively within a team environment.
  • Capability to manage multiple tasks and meet tight deadlines.
  • Excellent problem-solving skills are a must.
Licensing:

Driver's License is required.

Work Schedule:

Monday to Friday, Day shift.

Compensation:

Hourly rate ranges from $18 to $23, depending on knowledge and experience.

Remote Work:

This position does not offer remote work options.

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