Our Billing Specialists follow patient accounts through the entire billing process after charge entry to completion of payment process. Perform functions as related to medical billing and collection processes by following up on outstanding claims, submitting appeals, researching eligibility and benefits, posting insurance and patient payments when applicable, discussing and collecting patient balances and assisting clinic sites with billing questions. The Billing Specialist directly affects the unit of clinic profitability by following up for payment of previously coding visits and procedures. The incumbent resolves issues with insurance companies regarding incorrect registration information, claims processing, contract reimbursement amounts and coding issues.

Daily Job Duties:

• Responsible for keeping current on requirements related to Medicaid and MCO Payers
• Posting insurance (medical, dental, vision or pharmacy) payments/denials as assigned
• Performing work log tasks daily to ensure encounters/claims are corrected before billing is submitted or once claim is rejected/denied. This includes all assigned tasks in your assigned payers’ worklist including but not limited to (AR tasks, Change in Payer Tasks, Posting Denial Tasks, Tasks sent by Coding, Tasks sent by EDI regarding rejections…) Priority tasks to be completed within 5 business days of the create date.
• Produces reports to reduce age balances (AR) for assigned payers by contacting insurance companies for payment, working appeals, sending corrected claims and reconsiderations or sending secondary claims in a timely manner
• Works a minimum of 60 encounters/claims per day for Medicaid/MCO/County Indigent/Medicare plans and a minimum of 40 encounters/claims per day for Commercial/Medicare Advantage/Market Place plans
• Works claim denials within 5 business days of creation through Revenue Health Systems Denial Management System
• Submits Monthly Write Off Spreadsheets timely ensuring claims are worked before the filing deadline to avoid past timely filing write offs
• Works assigned patient refunds by the monthly deadline through Refund Manager
• Works assigned insurance refunds via paper by the monthly deadline
• Works organizational reports as assigned including but not limited to (patient balances, enrollment and payer audit reports)
• Works assignments with both accuracy and efficiency to reduce errors in all areas related to encounters within the NextGen billing system including but not limited to (Change in Payers, adjustments, balance control, refunds, reading balances/credits)
• May provide training on areas of expertise such as change in payers and payer assignments as needed
• Communicate with coding staff for timely resolution of coding denials
• All other duties as assigned including but not limited to (helping with department projects and working payers outside of your assigned payers)

Customer Service:

• Answers incoming calls to the billing department through PureCloud timely and with professionalism utilizing AIDET and LOC skills
• Provides customer service to patients by educating them on insurance policies and billing procedures
• Provides customer service to LSCC clinic staff by educating them on insurance and billing procedures
• Provides customer service to Insurance Companies while calling to check claim status, submitting appeals/reconsiderations over the phone and while checking status on overpayment requests

REQUIRED EXPERIENCE, EDUCATION, AND LICENSE:

• Minimum of a high school diploma and/or GED
• Minimum, two (2) years of medical billing experience and/or two (2) years of electronic medical records experience

PREFERRED EXPERIENCE, EDUCATION, AND LICENSE:

• Proficiency with MS Office Suite (Word, Excel, and Outlook)
• Bilingual English/Spanish language skills are a definite plus

Job Type: Full-time

Pay: $16.00 - $19.00 per hour

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• What are your salary expectations?

Education:

• High school or equivalent (Preferred)

Experience:

• Medical billing: 2 years (Preferred)

Work Location: One location

Please Note :
bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.