Medical Billing and Collections Professional

3 weeks ago


San Antonio, Texas, United States Muscogee Nation Business Enterprises Full time

Overview

Muscogee Nation Business Enterprises seeks a highly skilled Clinical Revenue Cycle Specialist to manage and pursue outstanding patient accounts. This role involves contacting patients and insurance companies to resolve billing discrepancies and escalate delinquent accounts when necessary.

Salary

$62,000 - $82,000 per annum, based on experience and qualifications.

Job Description

The Clinical Revenue Cycle Specialist will be responsible for:

  • Managing and working assigned queues for follow-up, denials, and billing errors of medical claims within company guidelines.
  • Pursuing appeals and taking the necessary steps to bring accounts to resolution.
  • Analyzing accounts for errors, adjustments, and credits, issuing corrected entries when necessary.
  • Investigating accounts to identify any unusual issues affecting payment delays.
  • Reviewing payments received in accordance with benefits quoted by the payer's Explanation of Benefits (EOB).
  • Identifying billing errors and/or posting errors utilizing the EOB.
  • Correcting billing and posting errors within 48 hours.
  • Processing remaining balances that are uncollectable per guidance in the billing system with the appropriate codes.
  • Analyzing and identifying denial trends and presenting findings with recommended course of action to the site supervisor and/or manager.
  • Extracting information regarding patient treatment from medical records and working closely with coding staff to compose individualized appeal letters.

Required Skills and Qualifications

The ideal candidate will possess:

  • A Certified Professional Biller (CPB) or Certified Billing and Coding Specialist (CBCS) certification.
  • An associate college degree in medical billing/coding and a minimum of 3 years of experience in private sector healthcare, within the past 5 years.
  • Experience working with a variety of health insurance companies, Medicare/Medicaid, as well as medical billing and collections.


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