What are the responsibilities and job description for the Medical Billing Specialist position at Global Technical Talent, an Inc. 5000 Company?

Medical Billing Specialist

Job Description:

The position of Medical Insurance Collector - Level I, II, and III is within our INR Revenue Cycle located at Livermore, California.
In this role, the Medical Billing Specialist will handle and resolve all insurance follow-up and denial issues to ensure that the company receives correct reimbursements from the insurance companies.
The incumbent will:
Serve as the liaison between insurance companies, patients, and the departments;
Ensure claims are processed and followed up to meet company goals of account receivable days, aging account percentages, and cash goals;
Research and answer all questions and complaints, regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism.
This job description will be reviewed periodically and is subject to change by management.

Job Responsibilities:

Collector Level I

Demonstrates proficiency and accuracy in operating systems directly related to specific job functions.
Initiates contact with insurance carriers regarding the status of claims.
Maintains accurate and complete collection notes concerning collection activities on all accounts according to company procedures and requirements.
Can work independently.
Takes incoming calls from insurance carriers and patients.
Contributes to team effort by accomplishing related results as needed.
Ensures that all processing and reporting deadlines are consistently achieved.
Maintain compliance with all company policies and procedures.
Regular attendance and punctuality.
Performs any other function as required by management.

Key Results:

Represents the company and team in a professional and positive manner.
Meet and exceed daily and monthly production goals.
Effective communications with staff and management.
Demonstrates a basic understanding of billing system; able to complete basic tasks based on job function.
Adapts to changing business needs, conditions, and work responsibilities.
Able to toggle between computer screens.
Exhibit competency in the utilization of computers, telephones, calculators, fax machines, and devices-level of competency 90%.

Collector Level II

Follow work list prioritization of accounts as established by department policies and procedures.
Responsible for all aspects of follow-up on accounts, including contacting payers and patients when necessary and accessing payer websites.
Accurately document accounts collection notes.
Responsible for processing appeals and researching claims.
Follow specific payer guidelines for appeals submission.
Prioritize and manage accounts to resolve high-priority-high dollar accounts and aging.
Complete AR adjustments where appropriate.
Demonstrates knowledge of government payers guidelines (Medicare/Medicaid).
Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPPAA and PCI compliance requirements).
Regular attendance and punctuality.
Performs any other function as required by management.

Key Results:

Working Denials in a timely manner that results in cash collection goals.
Represent the company and team in a professional and positive manner.
Meet and exceed daily and monthly productivity goals.
Detailed-oriented, careful, and with a focus on quality in accomplishing tasks.
Able to toggle between computer screens
Issues are identified and resolved within an average of 48 hours.
Adapts to changing business needs, conditions, and work responsibilities.
Effective communications with staff and management.
Always maintain confidentiality.
Present ideas for improvements and strategies to meet goals. Offer viable solutions to problems.
Promote teamwork, and remain available to assist staff as needed.
Performs any other function as required by management.
Report to the manager any non-compliance with staff as observed by you.
Participate in personal development training and cross-training as instructed by management.

Basic Qualification| Education:

High school diploma or GED required
Associate degree preferred
Preferred years of experience - Level one representatives 1 to 3, Level two representatives 3 to 5, and Level three 5 .
Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers.
Excellent computer proficiency (MS Office - Word, Excel, and Outlook)
Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
Ability to work independently and to carry out assignments to completion within parameters of instructions given prescribed routines, and standard accepted practices

Job Competencies:

Behavioral Standards:

Exhibits customer and service-oriented behaviors in everyday work interactions.
Demonstrates a courteous and respectful attitude to the internal workforce and external customers.
Treat others with unconditional respect, dignity, and equality

Communication/Knowledge:

Provides accurate and timely written and verbal communication of information in a manner that is understood by all.
Able to listen, understand, problem-solve, and carry out duties to ensure the optimal outcome.
Able to use IT systems in an accurate and proficient manner.

Collaboration/Teamwork:

Contributes toward effective, positive working relationships with internal and external colleagues.
Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization

Benefits:

About The Company:

Our client is a globally diversified healthcare company with a central purpose of helping people live their healthiest possible lives. They offer a broad portfolio of market-leading products that align with favorable long-term healthcare trends in both developed and developing markets. Working with this company, you'll tackle a wide array of problems including some of the world's greatest healthcare challenges while experiencing myriad cultures, geographies, and technologies. They are creating the future of healthcare through life-changing technologies and products that make you healthier and stronger, quickly identify when you have a medical need, and treat conditions to help you get back to doing what you love. It serves people in more than 160 countries with leading medical devices, diagnostics, nutrition products, and branded generic medicines.
If you are looking for a great company to work for, look no further because our client has received an average of a four-star rating from its thousands of employees that have written positive reviews on Glassdoor and Indeed.

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24-11498

Salary : $1 - $27

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Medical Billing Specialist