What are the responsibilities and job description for the Medical Billing Specialist position at Converge Medical Technology?
Exciting Medical Billing Specialist Opportunity! Are you ready to take your career to the next level? At Converge Medical Technology, we provide game-changing technology with empowering personalized patient services as part of our supervised physical therapy program. The Medical Billing Specialist role maintains the financial integrity of CMT Billing and Accounts Receivables by actively and reviewing and carrying out essential Billing and Collections functions. The ideal candidate must have experience with Workers' Compensation claims, prior authorizations and comfortable working with Adjusters, Nurse Case Managers, and Claims reps.
Key Responsibilities :
- Ensures accurate and timely billing of HCFA 1500 claims.
- Understands CPT, ICD10 and HCPC coding.
- Make outbound telephone calls to insurance companies for claims resolution.
- Follows existing billing / collection protocols to ensure accurate and timely reimbursement.
- Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.).
- Collaborates / coordinates with Utilization Review for prior authorization / medical necessity documentation.
- Appeals denied claims, front in authorizations as well as back end denials.
- Calls insurance companies and uses carrier websites in collection efforts.
- Reviews accounts receivable accounts to ensure accurate reimbursement and Identify payor issues affecting payment delays.
- Responsible for the DME business aspects of arranging care regarding insurance verification, coverage limits and identifying and qualifying medical documentation requirements as applicable.
- Manage incoming referrals and maintain track of all inquiries and responses provided.
- Utilize Salesforce to conduct day-to-day business responsibilities according to standard operating procedures.
- Responsible for incoming and outgoing, high volume telephone calls acting as liaison for insurance companies and sales reps to process prior authorizations, appeals and updates.
- Research required information using available resources to complete referral submissions and updates.
- Abide by all HIPAA, Confidentiality and Privacy laws
Qualifications :
Location : In Person in Austin, TX
Pay Range : $22- $24 / hr
Salary : $22 - $24
