Medical Biller

ProNexus, LLC is seeking an experienced Medical Billerto join our Firm.

Joining ProNexus offers the opportunity to work with diverse clients and tackle challenging projects that will expand your skills and expertise in the field of accounting and finance.

Enjoy the freedom and flexibility to choose your engagements, manage your workload and control your work life balance.

If you are a motivated and dedicated professional looking for a rewarding career opportunity, we encourage you to apply and become part of our team.

Attributes of our consultants include: commitment to unparalleled client service, adept at navigating complex and dynamic scenarios, possessing strong communication acumen, and proficient in problem-solving, execution, and knowledge transfer. Skilled in multitasking to efficiently meet diverse demands of our clients.

About the Role:

• Start Date: 9/3/2024
• Duration: Estimated 3-6 months
• Location: Remote
• Pay Rate: Competitive pay commensurate with experience
• Contract to Hire Possibility: Yes, possibility

Job Duties:

·Independently prepares claims for processing to third party payers utilizing electronic and/or paper systems when appropriate including by not limited to: o Reviewing registration demographics on patient accounts - Referral/authorization requirements, Charges, Coding, Payments

·Communicates with appropriate areas if discrepancies are found in claim data and follows through with appropriate actions to correct or report for resolution.

·Responsible for understanding and accurate application of contract provisions within payer area.

·Identifies areas that are not in compliance and works with appropriate leadership to resolve.

·Maintains working knowledge of other payer area contractual arrangements in order to coordinate patient claims which may cross from one payer to another.

·Monitors and controls accounts receivable.

·Maintains secondary as well as primary payer billing in order to meet and/or exceed department goals.

·Works independently with the ability to use judgment to recognize errors. Investigates and resolves billing discrepancies and problems.

·Researches and resolves patient and insurance company inquiries.

·Instructs and assists patients in informing them of avenues to pursue in having their account processed by insurance and completes necessary paperwork for processing of their account.

·Seeks assistance from manager or director in identifying and reporting problems or concerns within payer area or department that cannot be independently resolved.

·Accurately and thoroughly documents all action pursued on accounts. Maintains appropriate and accurate filing system which includes updated handbook of insurance carrier bulletins which document procedural and regulatory agency enhancements.

·Takes on special tasks assigned by the manager or director.

Maintains excellent customer skills to deal with payer representatives, difficult and/or angry customers. Conducts themselves in a professional manner with all they are in contact with.

·Receives phone calls from all customers in a warm, friendly manner. Professionally soothes, solves, or redirects patient concerns

·Answers phones promptly, politely screens, directs or forward calls to address the caller’s needs.

·Maintains and honors confidentiality policy including HIPAA regulations.

· Works closely with associates to support efforts to maintain an efficiently run department.

Qualifications:

-Associate's Degree

-2 years of Medicaid Billing experience

- Strong knowledge of medical terminology, records, and coding ICD-9, ICD-10

- Strong working knowledge of EMR/EHR systems or related billing systems

About ProNexus

ProNexus is a professional services firm that delivers business solutions and consulting services to help companies manage and execute their finance, accounting, and IT projects and initiatives. At ProNexus, our consultants and project professionals have an average of 7-20 plus years of experience and they bring a higher degree of competency, quality, and productivity at a more competitive value than other traditional consulting and Big 4 firms.

ProNexus is an equal opportunity employer and values diversity in the workplace. We do not discriminate on the basis of race, color, religion, gender, sexual orientation, age, marital status, veteran status, or disability status.

Job Types: Full-time, Contract, Temporary

Pay: From $28.00 per hour

Expected hours: 37.5 – 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Location:

• New York State (Required)

Work Location: Remote

Salary : $28