Medical Billing Specialist/Insurance Verification Specialist - Experience Required

To succeed in this role, an individual must possess in-depth knowledge of billing practices. Individuals must also have current knowledge of Medicare, Medicaid and Commercial Insurance practices as well as denial management abilities. We also require our team to demonstrate excellent written and verbal communication skills, as a large part of our business requires communication with clients, patients, and payers. Our company uses multiple EMR/PM systems which require quick learners, with strong computer skills. As with many Healthcare companies we are everchanging and require someone with the ability to think critically and be flexible as a part of the team in our fast-paced business.

Roles and Responsibilities

Insurance verification, understanding different payors and coverage is a requirement. Being able to find specific coverages and articulate the coverages to staff and clients. Obtain prior authorizations as needed.

· Review and scrub claims, correct all errors prior to submission.

· Prepare and submit medical claims and billing, including adding prior authorization, data to payers.

· Ensure the appropriate place of service for CPT is selected, apply appropriate modifier when required.

· Examine patient bills for accuracy and request any missing information.

· Assist patients with payment plans.

· Monitor and record late payments.

· Follow up on missed payments and resolve financial discrepancies.

· Prior to running month end send patient statements.

· Post all incoming payments daily.

· Reconcile bank deposits.

· Prepare daily, weekly, and monthly reports as required including month end.

· Maintain billing software by updating fee schedules on an annual basis. Formula is Medicare allowed amount times 150-175% (request supervisor approval on percentage) based on practice preference.

· Investigate and appeal denied claims.

· Work AR weekly, check payer portals, call insurance companies to collect outstanding claims.

· Required AR work is 60-90 days should be less than 15%, 91-120 less than 10%, over 120 under 8% of the total outstanding AR of the practice. Detailed work on these claims is required weekly.

· Stay current on new regulations and requirements from all payers as well as updated codes.

· All other duties as assigned.

Qualifications and Education Requirements

· High school education or equivalent experience.

· Certifications not required but recommended.

· Minimum of 2 years’ experience as a medical biller or similar role.

· Must have the ability to multitask and manage time effectively.

· Excellent written and verbal communication skills.

· Outstanding problem solving, attention to detail, and organizational skills.

· Microsoft office suite experience.

Job Types: Full-time, Part-time

Expected hours: 10 – 40 per week

Benefits:
• Flexible schedule
• Paid time off

Work Location: Remote

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