We invite you to join our dynamic team of pediatric professionals to make a difference in our community and grow in your field with the support and tools of one of the region’s top children’s rehabilitation organizations!

We are recruiting for a Full Time medical billing/medical collections representative to join our skilled team of professionals in Marlton, NJ! This position is eligible for our full benefits package!

POSITION SUMMARY:

• The Medical Billing/Medical Collections Representative is responsible for the Billing of Inpatient Services, Outpatient Services and Medical Day Care Services. They will monitor denial activity to process reconsiderations and appeals. They should be knowledgeable of all current Payer policies. The Billing/Collections Representative will maintain a good working relationship with all staff to ensure clear communication. Effectively interacts with families, other departments and payers while maintaining a standard of professionalism. Obtains medical records through EMR for reconsideration purposes. Understand and apply payer coverage, payer rules, payer reimbursement policies and medical policies. Utilize all appropriate systems to effectively research claims and complete steps to submit information necessary to process or appeal denied claims. Complies with adjustment and appeal or reconsideration in conjunction with each service area’s Coding and Reimbursement guidelines.

• Manage Medicaid, Medicaid Replacement and 3rd party claims and accounts receivables as it relates to Inpatient and Outpatient Services.
• Will be responsible for reviewing claims in the electronic health record for accuracy as well as submission of claims electronically and via paper when required.
• Will monitor electronic claims to ensure successful transmission to clearinghouse.
• Must be able to understand and read the Explanation of Benefits (EOB).
• Responsible for tracking and reviewing denial EOB’s
• Responsible for following up on unpaid and denied claims on a weekly basis.
• Responsible for reviewing failed activity and claims reports to fix or escalate any errors prohibiting claims from generating or transmitting.
• Responsible to review A/R reports as it relates to open charges for non-payment including but not limited to: short payments, ineligibility, inaccurate diagnosis, inaccurate coding and no authorizations on a weekly basis.
• Responsible for communicating effectively any trends relating to failed activities/claims, claim denials, or process issues to the Collections Lead.
• Verify insurance eligibility and demographics through Navinet, PEAR, Avility, NJMMIS as well as over the phone.
• Demonstrate knowledge and skills necessary to provide appropriate customer service to consumers with regards to account collections.
• Minimum 3 years of medical billing experience.