Medical Claims Specialist with High-Level Insurance Knowledge
6 days ago
Advanced Behavioral Health, Inc. is a mental health program that offers a comprehensive approach to treatment.
Salary and BenefitsThe estimated salary for this position is $24.375 per hour based on industry standards in the Frederick, MD area. The full-time employee benefits package includes:
- Medical, Dental, Vision
- 401(k) Retirement Plan with Employer Match
- Dependent Care Flexible Spending Accounts (FSAs)
- Voluntary Term Life Insurance
- Employer Paid: Basic Life Insurance, Short-Term Disability, Long-Term Disability
- Voluntary Insurance Policies: Accident, Cancer, Critical Illness, Hospital Confinement
- Employee Assistance Program (EAP)
- Paid Holidays, 3 Weeks PTO/Year, Floating Holidays, Paid Birthday, Wellness Day
This Medical Billing Specialist role plays a crucial part in ensuring all patient encounters are properly billed and reconciled through the clearinghouse process and ultimately paid by the insurer. The successful candidate will work under the supervision of the Billing Supervisor, producing weekly aging and reconciliation reports showing the status of all account encounters.
Required Skills and QualificationsTo excel in this role, you will need to demonstrate strong organizational skills, the ability to manage multiple priorities with minimal supervision, and excellent analytical and problem-solving skills. A bachelor's degree in business or a related field is preferred, along with experience working with health insurance claims and referral processing. Ideal candidates have a background working with electronic medical record systems within a healthcare organization.
Key Responsibilities- Perform daily review and processing of all patient encounters for payment by insurers through ABH's electronic medical records system.
- Resolve open and incomplete encounters so they can be billed.
- Resolve all claim denials and unpaid claims and resubmit when necessary.
- Prepare weekly aging reports and submit to Billing Supervisor and Comptroller for review.
- Collaborate with providers and insurers to resolve issues pertaining to denied claims.
- Maintain a tracking system of incoming and late payments.
- Request relevant information from appropriate clinical staff as required.
- Provide customer service to employees, management, and outside vendors/agencies.
- Adhere to professional standards, practice policies and procedures, federal, state, and local requirements, and CARF standards.
- Assist with other duties as needed within the Billing Department.
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