What are the responsibilities and job description for the Billing Specialist position at QuadMed?
Creating a better way. It’s more than just the philosophy we were founded on. It’s our purpose. For our employees, it means more time with patients. Unrushed visits to build meaningful relationships. And most importantly, an opportunity to empower our patients to achieve their full potential – at work and in life. Determined to make a difference? Join our health care revolution and be a part of something better.
GENERAL PURPOSE OF JOB
Responsible for working in our EMR alongside our billing team to help manage claim edits and errors, and resubmissions to our TPA’s on behalf of our clients. The billing specialist will handle inbound calls to accept payments and answer all billing questions, while providing outstanding customer service to the patient.
Schedule: Hybrid, must be located in the Sussex area
KEY RESPONSIBILITIES
- Assesses claims to verify correct billing
- Completes assigned systematic checks to ensure all billable claims are transmitted and processed in a timely manor
- Post remits from third party payers
- Follows-up with insurance companies regarding denials of payment
- Verifies all systems are balanced at the end of the date of service
- Corrects, both preemptively and post submission upon denial or rejection, claims errors
- Follows up on unpaid claims within the standard revenue cycle timeframe
- Works collaboratively with management to identify system and TPA issues to evaluate trends
- Maintains a solid understanding of current medical billing rules, laws and regulations
SCOPE
Will work collaboratively with clinical, medical billing and coding staff, supporting health and wellness center-based staff as well as corporate staff based on client needs.
JOB REQUIREMENTS
Education:
- High school diploma
Experience:
- Minimum one (1) year medical billing experience and a background in EPIC
Knowledge, Skills & Abilities:
- A working knowledge of insurance guidelines
- Effective communication skills
- Strong ethics and a high level of personal and professional integrity
- A working knowledge of current medical billing, coding and collections rules and requirements
- Ability to work in a team environment
- Ability to work efficiently and maintain accuracy
- A strong understanding of healthcare compliance to regulations including HIPAA, OIG, and AMA rules and guidelines
- Proven ability to work successfully with diverse populations and demonstrated commitment to promote and enhance diversity and inclusion
Harry Quadracci was determined to do things differently, and to do them better. In 1991, the visionary print manufacturing CEO founded QuadMed out of the belief that there had to be a better way to provide his employees with access to affordable, high-quality health care. And what started as doing the right thing, ended up sparking a health care revolution. Now 30 years later, we partner with employers across the nation to provide value-driven health and wellness services in or near the workplace. With a focus on breaking down cost, access and quality barriers, we empower employees and their families to live healthier, happier lives.
We offer excellent benefits to eligible employees, including 401(k), holidays, vacations and more.
QuadMed and Quad is proud to be an equal opportunity employer and values diversity. We are committed to creating a place of belonging — a space where employees do not need to sacrifice who they are to exist and grow in our workplace. QuadMed and Quad does not discriminate on any unlawful basis including race, religion, color, national origin, disability, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or any other basis prohibited by applicable federal, state, or local laws. QuadMed and Quad also prohibits harassment of applicants and employees based on any of these protected categories.
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