Medical Biller

Description

Seeking a Billing and Credentialing Specialist - 1 FTE position for growing local sleep medicine (single specialty) practice with 3 providers. Experience billing for DME (HCPCS) codes is a plus. Experience using Athena health EHR important.

JOB SUMMARY

Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote financial health. This position ensures acceptable reimbursement and appropriate days in Accounts Receivables with timely account follow-up and resolution of outstanding charges owed by third party payors. Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization.

ESSENTIAL FUNCTIONS

1. Resolve insurance claim rejections/denials, and non-payment of claims by payors.

2. Identify trends in billing and follow-up, maintaining working knowledge of state and federal billing guidelines in order to identify ways in which our patients can expedite resolution of insurance accounts and identify delays in processing.

3. Responsible for drafting effective appeals to insurance companies for reimbursement of monies owed.

4. Responsible for maintaining daily account and follow-up work lists

5. Work with DME specialist to ensure CPAP and BiPAP machine billing is appropriate and timely.

6. Responsible for identifying, researching, and resolving: credit balances, missing payments and unposted cash as it pertains to billing account follow-up.

7. Process, and maintain, within expectation, all correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.

8.Responsible for handling patient disputes and submission of issues to coding for review to ensure organizational and revenue cycle processes are followed.

9. Communicate appropriately with insurance companies, patients, co-workers and supervisors.

10. Perform credentialing and other duties as needed.

QUALIFICATIONS

EDUCATION:

• Associates Degree or Medical Billing Certificate preferred

EXPERIENCE/TRAINING:

• Minimum of two years’ experience in a billing or insurance account follow-up capacity is required; Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered
• Medical terminology experience required
• Knowledge of insurance processes and billing guidelines regulations required
• Coding knowledge preferred
• Athena Health experience required.
• Brightree experience would be appreciated.

OTHER SKILLS:

• Proficient use of computers including Microsoft Office 2010 applications
• Skilled in 10-key by touch and keyboarding
• Ability to operate general office equipment
• Exceptional verbal and written communication skills
• Excellent attention to detail and ability to multi-task
• Ability to work with minimal supervision, independently, as well as in a collaborative team setting
• Strong organizational skills with the ability to prioritize and meet deadlines
• Knowledge of Commercial and/or Government Payors
• Ability to identify, research, and resolve credit balances, missing payments and unposted cash as it pertains to billing account follow-up

PHYSICAL/COGNITIVE REQUIREMENTS:

• Work requires fairly light physical exertion from up to 65% of the time.
• Ability to lift objects weighing 30 lbs. or less.
• Work is performed under normal working conditions with adequate lighting and ventilation.
• Job duties frequently require intense concentration and attention to detail (up to 65% of work time).
• Ability to work from home if COVID Pandemic recommendations recommend this.