Medical Billing Specialist
4 weeks ago
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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