Medical Claims Billing Specialist (Fulltime Temp)

About the role

This full-time position is a hybrid role that requires working in the office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but may be in office on occasion.

Responsibilities

• Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; suggesting billed rules/edits when appropriate to stop errors from occurring
• Denial management - investigate denial sources, resolve and appeal denials which may include contacting payer representatives
• Make 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
• Support large care center go lives when applicable, which may include overnight travel
• Work closely with our Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements
• Perform denial analysis utilizing the Trizetto platform
• 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)
• Other duties as assigned

Qualifications

• High School Graduate
• 3+ years experience in a medical billing office or equivalent claims experience
• 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
• Experience with athenaHealth and/or athenaOne preferred
• Must comply with HIPAA rules and regulations

Pay

The hourly range for this role is $25.00-$26.45. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Schedule

This role is a hybrid role requiring working in the office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but may be in office on occasion.