Medical Claims Billing Specialist

About the role

This position is a hybrid full-time role that requires in-office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but subject to change for internal meetings, trainings, and conferences.

Responsibilities

• Investigating denial sources, resolving and appealing denials which may include contacting payer representatives
• Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Collaborate with internal teams (Performance, Operations, Sales) as well as care center staff when appropriate
• Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
• Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team-focused approach to attainment of these goals
• Other duties as assigned

Qualifications

• Education: High School diploma
• 3+ years medical claims experience in a physician medical billing office
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred
• Must understand Explanation of Benefit (EOB) statements
• Google Suite experience preferred
• Athena EMR experience preferred
• Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely for days not in the office
• Comfortable speaking in front of groups
• Excellent written and verbal communication
• Willingness to train and mentor other team members
• Self-starter with great time management skills
• Ability to work independently and multi-task in a fast-paced environment
• Problem solver with good analytical skills and solution-oriented approach
• Independent decision maker with strong research skills

Skills

• Understanding of revenue cycle optimal performance
• Advanced Microsoft Excel skills
• Understanding of Explanation of Benefit (EOB) statements
• Google Suite experience
• Athena EMR experience
• Accessibility to private, quiet work space with high-speed internet
• Speaking in front of groups
• Excellent written and verbal communication
• Training and mentoring other team members
• Independent decision making
• Strong problem-solving skills

Benefits

The hourly range for this role is $24/hr - 26.45/hr in base pay and exclusive of any bonus or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10% based on performance in the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Pay

The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Schedule

This role is a hybrid full-time role that requires in-office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but subject to change for internal meetings, trainings, and conferences.