Medical Billing Specialist
5 days ago
We are seeking a highly skilled Medical Billing Specialist to join our team at Montefiore Medical. As a member of our revenue cycle department, you will play a critical role in ensuring the smooth and efficient processing of patient fees. With a focus on delivering exceptional customer service and maintaining high levels of accuracy, this is an exciting opportunity for a detail-oriented professional to make a real impact.
About the Role
In this dynamic position, you will be responsible for collaborating with clinical staff to obtain necessary documentation for billing purposes, entering financial data into our program's billing database, and resolving denied payments. Your strong analytical skills and ability to work effectively in a fast-paced environment will enable you to identify and address potential issues promptly, ensuring timely payment and minimizing losses. A key aspect of this role is maintaining relationships with insurance companies, Medicaid, and NYC department of finance, as well as developing reports to track weekly scheduled visits and identifying opportunities for process improvement.
Key Responsibilities
- Collaborate with clinical staff to obtain necessary documentation for billing purposes
- Enter financial data, including Medicaid numbers, gender, date of birth, and other insurance codes into our program's billing database
- Set all weekly rates using a sliding fee scale and documentation provided by the patient
- Review requests from the clinic for adjustment of patient weekly fees and balances
- Identify and contact clinical staff regarding patients who are delinquent in paying for program services
- Review, process, and monitor billing for claims service claims, including OTP, HIV Counseling, Case Management, and Testing, HIV Primary Care, Chemical Dependency, and patient transportation
- Ensure billing is scheduled and collections are reviewed on a continuous basis
- Maintain contact with program's billing services, insurance companies, Medicaid, and NYC dept. of finance
- Compute and submit revenue deposits posted on a general ledger and reported on grants
- Bill private insurance carriers for patients whose care is reimbursable through these companies
- Maintain records of patients with private insurance
- Prepare and submit claims, re-billing denied claims, and back-billing claims to Medicaid and other accepted insurances
- Maintain database reconciliation
- Review denials and enter corrections into billing database
- Develop reports to track weekly scheduled visits
- Perform other duties as assigned
Requirements
- High level of proficiency with MS Office (Word, Excel), medical databases (EPIC, office ally, IMA)
- Must type 25 Words per minute
- High School Diploma / GED required, medical billing and coding preferred
- 3 + years of working experience as a Medical Coder (CPC strongly preferred) with insurance verification and authorization is a must
- Must have strong knowledge of CPT and ICD-10 billing codes and knowledge of Medicaid and commercial insurance billing
- Must be detail-oriented, able to meet strict deadlines, and have strong customer service skills to be able to interact with patients and industry professionals
What We Offer
This is a full-time, 100% grant-funded position offering a competitive salary range of $26.64 per hour. Located in the Bronx, NY, this role offers the opportunity to work with a renowned healthcare organization and contribute to the delivery of excellent patient care.
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