Medical Billing Specialist

4 weeks ago


Dublin, Ohio, United States Total Care Therapy Full time
About the Role

Total Care Therapy is seeking a highly organized and detail-oriented Medical Billing Specialist to join our team. As a key member of our administrative staff, you will be responsible for ensuring the smooth operation of our medical billing process.

Key Responsibilities:

  • Process initial and re-credentialing applications from providers, ensuring compliance with departmental requirements.
  • Accurately enter application data, conduct reviews for errors before submitting provider files for quality review, and meeting departmental requirements.
  • Process a minimum number of provider applications each month, adhering to departmental requirements.
  • Perform follow-up for provider files on "watch" status, as required by departmental guidelines.
  • Ensure timely follow-up for ongoing state license action monitoring reports.
  • Ensure timely follow-up for ongoing Medicare/Medicaid sanctions monitoring reports.
  • Prepare and distribute re-credentialing groups, meeting departmental requirements.
  • Complete 1st, 2nd, and 3rd requests for re-credentialing packets, as per departmental requirements.
  • Generate reports for various state plans/departments to identify providers who have not returned their re-credentialing applications or are past due for credentialing, adhering to departmental requirements.
  • Accurately logging of payments received from insurance companies and patients while maintaining current records and balances of all receivables.
  • Maintain current records including billing addresses and numbers for contacting patients as needed.
  • Follow up on delinquent payments and resubmit billing as needed.
  • Follow up on $0 pays.
  • Perform posting charges and completion of claims to payers.
  • Submit billing data to the appropriate insurance providers.
  • Process claims.
  • Resolve denial instances and filing appeals.
  • Assisting with faxing, answering phones, emails and text messages.
  • Assisting with credentialing new providers under insurances.
  • Running initial insurance verifications and benefits checks for new clients.
  • Bi-monthly re-verification of benefits.

Requirements:

  • Competent with Google Suite, Microsoft Excel, Microsoft Word, CMS 1500, and Availity.

What We Offer:

Competitive compensation based on experience.



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