Medical Billing Specialist

Rural Physicians Group is an expansive physician network of rural-focused hospitalist, surgicalist and APPs that are passionate about helping rural hospitals meet the needs of the communities we serve.  By working with Rural Physicians Group, our hospital partners receive full-time dedicated providers on site, filling a critical void in care coverage and allowing for better patient outcomes.  Better outcomes lead to expanded inpatient services. Expanded inpatient services revitalize the hospital.  And a revitalized hospital improves the entire community.

RPG’s mission is, “Bringing rural hospitals and providers together to enhance the care of their community.”

We are currently seeking a full time Medical Billing Specialist to help us with this mission. 

Essential Duties: May be required to do one or all of the following dependent on the business needs (including but not limited to):

• Patient demographic data entry
• Obtaining referrals and pre-authorizations as required for procedures.
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Follow through with ICD-10-CM standards or similar systems to code and abstract medical records
• Compile, organize, and maintain medical records relating to patient’s conditions and treatment with their electronic health record (HER)
• Analyze records for completeness, accuracy, and compliance regulations

Knowledge, Skills, and Abilities:

• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Competent use of computer systems, software, and 10 key calculators.
• Familiarity with CPT and ICD-10 Coding.
• Ability to research and navigate through CMS and other payer web portals to assist with RPG policies and procedures.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• A calm manner and patience working with either patients or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to multitask.
• Ability to work under minimal supervision.

Education and Experience:

• Minimum 2 years Revenue Cycle experience in a healthcare setting required
• Must have excellent computer knowledge of Patient Accounting systems
• Associates degree or equivalent; Bachelor’s degree in related field desired
• Experience with hospitalist inpatient and outpatient billing
• Coding certificate required

Benefits:

• Competitive Salary
• Incentivized bonus plan
• Ability to work remotely from home
• 3 weeks PTO – accrual starts your first day
• Insurance plans for medical, dental, and vision
• 401k Match
• Basic Life Insurance
• Cell Phone Allowance

Salary : $22 - $34