Employment Opportunities

General Description

Responsibilities

1. Post payments and adjustments in billing software using the Explanation of Benefits (EOBs) and Remittance Advice (RA) as reference document.
2. Verifies, and audits updated financial transactions.
3. Respond to correspondence received from insurance carriers or patients
4. Appropriately changes essential information needed for insurance carriers for redirection or status of initial claims
5. Manage/Reconciled denied claims and appropriately, and file appeals if needed.
6. Make outbound calls to insurance companies to research and gather necessary information for successful claim resolution
7. Make appropriate decisions on accounts to be worked to maximize reimbursement.
8. Identify any problems/trends and communicate them to the direct supervisor for resolution.
9. Must be able to communicate procedures for processing changes that may increase revenue from insurance carriers.
10. Reviews and reconciles transactions to ensure accuracy and completeness.
11. Provides requested information as assigned, creates or generates related reports or locate and pull requested information for drafts or documentation.
12. Gathers all paper checks to be deposited.
13. Enters data monthly in accounting software.
14. Assists Authorization Specialist and back up as needed.
15. Other duties as assigned

Education Requirements and Qualifications

• Education: High School Diploma / Some College Preferred
• 1-3 years of previous medical billing experience within a healthcare environment
• Ability to produce detailed work accurately and efficiently
• Excellent organizational skills
• Analytical and problem-solving skills
• Outbound phone experience
• Basic computer skills
• Intermediate web navigation skills
• Experience writing correspondence

• Knowledge of ICD-10 & CPT coding
• Knowledge of claim denials, adjustments, and write-offs
• Knowledge of collection procedures
• Knowledge of various payer groups (Medicaid, Medicare, Private insurance)