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Medical Billing Specialist

1 month ago

Clifton, New Jersey, United States Sutherland Full time
Job Title: Medical Billing/AR Specialist

Job Summary:

Sutherland is seeking analytical, detail-oriented individuals with strong communication skills to join our team as Medical Billing/AR Specialists. In this role, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed or sent to Legal.

Key Responsibilities:

  • Conducting collection activity on appealed claims by contacting government agencies, third-party payers via phone, email, or online
  • Providing ongoing appropriate collection activity on appeals
  • Requesting additional information from patients, medical records, and others as needed
  • Communicating with insurance plans and researching health plans for benefits and types of coverage
  • Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed
  • Handling 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

Work Environment:

This is a remote work opportunity, and you must have excellent internet connectivity, a quiet and distraction-free workspace, and a 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.