PAR I & II

Job Description

Job Description

We are looking for Medical Billing Specialists with experience in back-end A/R follow-up, resolution of aged accounts, and working denials for Hospital and/or Physician Billing. Our team assists healthcare providers and hospital entities with the remediation of 3rd party accounts receivable and a variety of revenue outsource capabilities. The primary role is to resolve assigned accounts by following up with commercial and government payers on denied, underpaid, or otherwise unresolved accounts and collecting insurance claim balances for the client. This position will require in-depth research and problem solving to get the resolution on these claims, while maintaining productivity and quality outputs for the assigned client.
Some of the additional benefits you will have working with us include: Permanent position Flex Schedule Excellent Health, Dental, Vision, Life Packages PTO, paid sick leave, paid holidays Opportunity for career growth
Responsibilities:
Performs second-tier account follow-up activities in accordance with organizational, client and regulatory guidelines for outstanding insurance receivables including, but not limited to:
Performing account follow-up activities on high-dollar accounts receivable
Research items requiring further assistance
Possesses an understanding of the healthcare revenue cycle and applies this knowledge to assist team with achievement of quality control standards
Demonstrates the ability to professionally communicate with colleagues, payers, and clients (if necessary)
Ensures accurate and complete account follow-up by demonstrating a thorough understanding of carrier-specific reimbursement as applicable to claim processing to include: eligibility discrepancies, UB-04 and/or 1500 claims form review, DRG, per diem, case rate, fee schedule reimbursements, etc.
Identifies and communicates A/R trends, payer behavior, workflow inconsistencies or other barriers to account resolution to team and engagement leadership
Researches and documents any correspondence received related to assigned accounts
Assess accounts for balance accuracy, confirm correct payer billed, coding accuracy, denials, and outstanding insurance requests
Provide documentation appropriately and submit corrections; or if payer error, escalate for re-processing in a professional and timely manner
Identify billing or coding issues and requests re-bills, secondary billing, or corrected bills as needed
Contacts third party payers and government agencies to resolve outstanding account balances
Maintains departmental productivity and quality standards
Must possess general PC aptitude and keyboarding ability -- must be able to type at a minimum of 40 wpm required
Ability to multitask in several applications and systems simultaneously and demonstrates competency with Microsoft Suite and assorted internet browsers required
Education and Experience:
A minimum of 1-2 years in Healthcare Provider Revenue Cycle experience required
High School Diploma or equivalent required; Associate's or Bachelor's Degree preferred
Hands-on experience using Epic, Cerner, Invision, Soarian, McKesson, Allscripts, Meditech, and other industry recognized Revenue Cycle Management Systems required
Hands-on knowledge of UB-04 and/or HCFA 1500 billing and account follow up, CPT and ICD-10 coding and terminology for hospital and/or ambulatory/physician billing
Physical Requirements: While performing the duties of this job, the employee is frequently to use hands, fingers; and frequently to talk or hear. The employee must exert up to 15 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or up to 5 pounds of force frequently, and/or a negligible amount of force constantly to move objects. The employee must have the ability to sit for long periods of time.