Billing Specialist
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Job Description
Remote Billing Specialist supporting medical groups through healthcare claim coding, billing, and payer-denial resolution. Managing accounts receivable, appeals, re-bills, documentation, and patient billing inquiries.
Responsibilities:
- Support complete and timely collection of revenue for assigned groups
- Perform accurate coding and entry of patient and charge information into the billing system
- Follow up on outstanding claims and/or charges
- Review and resolve payer denials, including appeals, coding corrections, and medical necessity rules
- Analyze and resolve billing issues, keeping A/R to no more than 10% over 60 days
- Process daily correspondence and claim status; handle denials, appeals, and re-bills
- Answer billing questions and inquiries from patients and internal staff
- Update patient files with address and contact information changes
- Review policy changes and inform the supervisor and charge entry specialist
- Navigate insurance companies’ proprietary websites to find policies and research payments
- Keep the supervisor apprised of accounts receivable matters
- Respond to billing company requests in a timely manner
- Research denials and submit corrected claims and medical documentation
- Review and manage claims in work-dashboard hold buckets for resolution
- Create, maintain, and update reports as directed
- Maintain confidentiality and comply with HIPAA rules and regulations
- Participate in and complete required trainings and in-services
- Perform other duties as assigned
Requirements:
- High School Diploma, or equivalent, with a minimum of three (3) years related experience; OR an equivalent combination of education and/or experience
- Must live in one of the states where the company currently operates: MD, DE, VA, NJ, PA, FL, AL, GA, SC, or TX
- Knowledge of Internet and Microsoft Office software, including MS Word, MS Excel, MS PowerPoint, and MS Outlook
- Excellent written and oral communication skills, including exceptional customer service
- Ability to establish and maintain effective working relationships with doctors, clinical staff, co-workers, and the public
- Ability to work individually and within a team
- Ability to follow verbal and written instructions
- Ability to work a flexible schedule
- Ability to respond with patience and understanding during stressful conditions related to patient health and emergent situations
- Ability to multi-task and prioritize
- Extreme attention to detail
- Strong organization skills
- Ability to problem solve and use reasoning
- Ability to meet predefined quality standards
- Professional attitude and appearance
- Working knowledge of CPT and ICD-10 coding rules
- Solid foundation of insurance knowledge and third-party payer guidelines
- Working knowledge of the healthcare field and medical specialty, as well as medical terminology
- Strong desire to provide excellent customer service
- Compliance with applicable organizational rules and regulations
- High ethical and professional standards of conduct
- Desire to continuously improve professional performance
- Reliable transportation
- Preferred: Two (2) years’ experience working with an Electronic Medical Record (EMR)
- Preferred: Medical Billing Certification
Benefits:
- PTO: Up to 96 hours in first year (pro-rated based on start date)
- 7 paid holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day After Thanksgiving, Christmas Day
- 401(k) with employer match
- Medical, dental, and vision benefits for single and family coverage
- Short-Term Disability
- Long-Term Disability
- Basic Life/AD&D
- Employee Assistance Program
- Voluntary Life
- Accident
- Critical Illness
- Hospital Indemnity
- Eligible for overtime pay in accordance with applicable law
- Flexible schedule
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