What are the responsibilities and job description for the Medical Billing & Denials Representative position at TEKsystems?
As the *Medical Billing and Denials Representative*
* *
*If you're ready to explore the next step in your career:*
* *
*You'll enjoy...*
*Career Opportunities* - Tons of growth opportunities for your career
*Standard Hours* - Hybrid role. Monday-Friday (7:30 am - 5:30 pm - flex shift option)
* Onsite during training
* Post training: Hybrid 3 days onsite, 2 days remote
* Once management feels confident in your performance - fully remote
*Competitive Pay* - $21.00-23.00 an hour
*Expedited Interviews* - Access to additional Resume support and pre-interview questions
* *
*A day in the role...*
* Investigate insurance denials and make necessary corrections to bring claim resolution.
* Ensure the correct primary and/ or secondary insurance was billed
* Prepare and submit appeals and or medical records to insurance companies
* Assist with identifying trends, aberrations and concerns related to billing and payer denials and communicates concerns to management.
* Ensure that payments and adjusted are posted per the EOB
* Responsible for running detailed A/R reports
* Work with the coding team to resolve coding related denials
* Respond to correspondences from payers in a timely manner.
* Assist patients with phone inquiries related to billing.
* Types of Reports:
* Adjustment report- daily report comes in and details the denials posted in the system from the previous day
* Aging report - display everything that is outstanding in the insurance AR that may need review (could be repetition from your adjustment and aging report) Monthly report that they will work daily throughout the month
* Coding list document - functions similar to Excel (Excel with tasks) you can create tasks and it goes to your email. Use this document to communicate with the coding team. If a coding denial populates to this report they communicate with the coder to review and then take action based on that
* Correspondences are being scanned in by one person and it is put on a log and sent to the team daily
* The Insurance Analysts are responsible for going through these reports daily and following up on the denials. To stay on track they will have to work 50-75 line items per day (you can have 5-10 line items in 1 encounter)
* There is also a rotating phone schedule - they do have a new role posted for someone to answer phones so may not need to help out but may need to assist with patient phone calls - calling to ask about patient bills (2-3 times per month)
*Necessary Skills and Strengths:*
AR Follow-Up | EMR/EHR Systems | Claims Processing | CPT/ICD-10 Codes | Rejections/Denials | Insurance Payer Knowledge | EOB | Coordination of Benefits
* *
*Core Experience:*
* Strong AR Follow-Up Experience (2 years of experience)
* Claims Processing
* Insurance Payer Experience
* Claims Denials
* EMR Knowledge (NextGen *huge plus*)
* Payer portal knowledge
*Pay and Benefits*
The pay range for this position is $21.00 - $23.00
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a hybrid position in Newport News,VA.
*Application Deadline*
This position will be accepting applications until Jan 28, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
* *
*If you're ready to explore the next step in your career:*
* *
*You'll enjoy...*
*Career Opportunities* - Tons of growth opportunities for your career
*Standard Hours* - Hybrid role. Monday-Friday (7:30 am - 5:30 pm - flex shift option)
* Onsite during training
* Post training: Hybrid 3 days onsite, 2 days remote
* Once management feels confident in your performance - fully remote
*Competitive Pay* - $21.00-23.00 an hour
*Expedited Interviews* - Access to additional Resume support and pre-interview questions
* *
*A day in the role...*
* Investigate insurance denials and make necessary corrections to bring claim resolution.
* Ensure the correct primary and/ or secondary insurance was billed
* Prepare and submit appeals and or medical records to insurance companies
* Assist with identifying trends, aberrations and concerns related to billing and payer denials and communicates concerns to management.
* Ensure that payments and adjusted are posted per the EOB
* Responsible for running detailed A/R reports
* Work with the coding team to resolve coding related denials
* Respond to correspondences from payers in a timely manner.
* Assist patients with phone inquiries related to billing.
* Types of Reports:
* Adjustment report- daily report comes in and details the denials posted in the system from the previous day
* Aging report - display everything that is outstanding in the insurance AR that may need review (could be repetition from your adjustment and aging report) Monthly report that they will work daily throughout the month
* Coding list document - functions similar to Excel (Excel with tasks) you can create tasks and it goes to your email. Use this document to communicate with the coding team. If a coding denial populates to this report they communicate with the coder to review and then take action based on that
* Correspondences are being scanned in by one person and it is put on a log and sent to the team daily
* The Insurance Analysts are responsible for going through these reports daily and following up on the denials. To stay on track they will have to work 50-75 line items per day (you can have 5-10 line items in 1 encounter)
* There is also a rotating phone schedule - they do have a new role posted for someone to answer phones so may not need to help out but may need to assist with patient phone calls - calling to ask about patient bills (2-3 times per month)
*Necessary Skills and Strengths:*
AR Follow-Up | EMR/EHR Systems | Claims Processing | CPT/ICD-10 Codes | Rejections/Denials | Insurance Payer Knowledge | EOB | Coordination of Benefits
* *
*Core Experience:*
* Strong AR Follow-Up Experience (2 years of experience)
* Claims Processing
* Insurance Payer Experience
* Claims Denials
* EMR Knowledge (NextGen *huge plus*)
* Payer portal knowledge
*Pay and Benefits*
The pay range for this position is $21.00 - $23.00
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a hybrid position in Newport News,VA.
*Application Deadline*
This position will be accepting applications until Jan 28, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Salary : $21 - $23
