Medical Billing Specialist

2 days ago

Amherst, Massachusetts, United States Dent Neurologic Group LLP Full time
Job Summary:

As a Medical Billing Specialist at Dent Neurologic Institute, you will play a vital role in ensuring the accuracy and efficiency of our billing processes. Your primary responsibility will be to initiate and coordinate the follow-up process for medical claims, reviewing and collecting on all submitted claims. You will work closely with our team to research and follow up on outstanding receivables via telephone, provider inquiry form, and written correspondence. Your attention to detail and organizational skills will be essential in documenting every claim with its current status of appeal, as well as call reference numbers and/or insurance representative information.

Responsibilities:

Follow up and denial process
Research and follow up on outstanding receivables via telephone, provider inquiry form, and written correspondence
Document every claim with current status of appeal, as well as call reference numbers and/or insurance representative information
Utilize all available resources and correct and appeal claims, including documentation of the service, medical literature, pre-certification, authorizations, procedure and diagnosis coding manuals, and reference materials
Understand the payer appeal process when claims appeal efforts do not succeed and know when and how to move to a formal appeal process
Construct a successful appeal letter and know what to include within each appeal
Work assigned insurance denial bucket
Work assigned follow-up claims
Work Medicaid claims by putting them through epaces
Responsible for working 45, 90, 120+ day aging claims
Negative balance claims and refunds
Meeting claim filing deadlines
Printing HCFA claims
EBO report generated every Monday for patients with balances
Process medical expense reports
Sort mail appropriately and work insurance correspondence
Strict adherence to Dent policies, refund policies, and other accounts receivable policies is required
Performs other duties assigned by Billing Manager, Team Lead, Sr. Revenue Cycle Manager, or CFO
Answer all phone calls in an effort to assist patients with billing questions
Ability to accept responsibility for appropriate conduct within the office setting and with other department associates by interacting calmly, respectfully, and in a friendly manner with other representatives of services at Dent
Maintains strict confidentiality of patient information
Completes duties in a time-efficient manner as set forth by the Team Leader. Reports errors or problems so that appropriate action may be taken for patient care

Requirements:

Must have understanding of the different insurance plans, contracts, and policies
Must know how to interpret EOBs, understand copay, co-insurance, deductibles, and retractions
Knowledge of other billing processes such as claims management, charge entry, payment posting, and patient financial clearance
Knowledge of insurance verification process, referral, and authorizations requirements
Knowledge of electronic claim submission
Understanding of patient check-in/check-out process along with a working knowledge of CPT, ICD-9, ICD-10, HCPCs, and Modifiers
Previous working experience in an outpatient medical practice
Medical terminology
Strong sense of urgency to work within deadlines
Ability to prioritize multiple tasks simultaneously in an occasionally stressful environment
Strong general office skills, including typing skills
Strong customer service, planning, problem-solving, and organizational skills
Working knowledge of Microsoft Windows programs, including Excel and Word
Working knowledge of general office equipment, including multi-line phone, computer, copier, calculator, and fax machines
Effective communication and interpersonal skills

Education:

High school diploma with a minimum of 2 years of medical billing experience

Preferred Education:

Associates degree in medical billing and reimbursement with a minimum of 1 year of medical billing experience

Working Conditions:

Normal working environment, typical of most office settings
Minimal physical effort, requires some lifting of files, usually not in excess of 15 pounds
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Compensation:

Most candidates will start within the first quartile of the pay range
Rates are commensurate with experience

EEO Statement:

Dent Neurologic Institute offers an inclusive work environment built on kindness and respect for all. Dent provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws as the basis for an employment decision. All qualified individuals are encouraged to apply and will receive consideration.

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