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Medical Billing and Collections Specialist
1 month ago
Contentnea Health is a Community Health Center providing comprehensive medical, dental and behavioral health services for members of our communities in eastern North Carolina.
We are seeking a skilled Medical Billing and Collections Specialist to join our team. The successful candidate will be responsible for submitting healthcare claims accurately and efficiently, researching and correcting denials and errors, and applying discounts and adjustments as needed.
Key Responsibilities
- Perform billing and collection activities for medical, behavioral health and dental services.
- Create claims submissions for assigned payers and/or patient accounts.
- Correct and resubmit rejected claims for assigned payers and/or patient accounts.
- Research, correct and resubmit denied claims for assigned payers and/or patient accounts.
- Follow-up with payers via the most effective channel to resolve outstanding claims.
- Identify credit balances for assigned payers and/or patient accounts and submit refund requests as appropriate.
- Identify account balances meeting the criteria for bad debt write-off and flag balances as appropriate.
- Post third-party payments for assigned payers and/or patient accounts accurately to charges.
- Review account balances for patients qualified for the Sliding Fee Discount Program and apply discounts to eligible patient charges.
- Perform work in accordance with departmental timelines for claims creation, submission, resolution of claim rejections and denials and open/unpaid claims.
- Assist with reconciliation of patient and payer payments as requested.
- Communicate with credentialing staff and/or external credentialing vendor as needed to ensure necessary enrollments and/or updates are performed to mitigate claims denials.
- Maintain all documents relevant to daily billing functions in internal data repository.
Requirements
Possesses specific knowledge and training in billing processes and practices, typically acquired during completion of a certificate program in billing practices with a duration of up to a year. Possesses a basic knowledge of medical terminology, procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing and of insurance policies and contracts for multiple insurance vendors. Current certification as a Community Health Coding and Billing Specialist (CH-CBS).
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