Medical A/R Billing Specialist

Primary Tasks/Responsibilities

• Process an average of 80 claims daily including follow up accounts.
• Review claims data to ensure the insurance sequence is correct for billing (primary, secondary, etc.).
• Submit claims for services rendered to insurance companies in a timely fashion.
• Verify patients’ insurance coverage.
• Work directly with the insurance company, the patient, and clinic staff to get claims processed and paid.
• Ensure patient demographics including name, date of birth, and insurance number are accurate on claims.
• Work closely with Third Party Liability (TPL), help patient’s update COBs.
• Know and understand CMS regulations for billing.
• Review and appeal denied and unpaid claims to resolve denial instances.
• Achieve maximum reimbursement for services rendered.
• Maintain and update patient AR balances.
• Scrub claims, timely follow-up for missing required items.
• Track and update the Aging Report, and work on patient accounts for accuracy.
• Answer questions from patients, providers, and third-party insurers about billing.
• Review patient bills for accuracy and completeness and obtain any missing information.
• Handle collections and unpaid accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients if there is a lapse in payment.
• Monitor and report billing error patterns.
• Cover Front Office locations as needed based on coverage needs.
• Sign in answer phone queues and emails for billing.
• Assist patients with the Sliding Fee Discount Program.

Education/Professional

• Minimum of 2 years of experience as a medical biller or denial specialist in primary care and behavioral health settings, highly preferred.
• Experience working with multiple third-party payers including Medicaid, Medicare, Managed Care, HMO/PPOs.

Knowledge, Skills And Competencies

• Strong knowledge of and ability to easily navigate Medicaid, Medicare, HMOs, and private payer systems.
• Knowledge of EMR systems, preferably with eClinicalWorks.
• Microsoft suite and data systems proficiency, including Electronic Medical Records.
• Effective communication skills, both written and verbal.
• Ability to effectively utilize problem-solving and decision-making techniques.
• Effective judgment and decision-making based on objective criteria.
• Demonstrated ability to work effectively and professionally with individuals from varied backgrounds and experiences.
• Attention to detail and strong organizational skills.
• High comfort working in a busy environment with changing priorities.

Benefits

• Sign on Bonus of $800 after 90 days of successful employment.