Senior Medical Billing and Coding Specialist

Senior Medical Billing and Coder Specialist

Looking for an experienced medical biller that has extensive understanding of Medicaid and commercial insurance billing, credentialing, collections, denial management, payment plans, and other arrangements. The ideal candidate will be compassionate and naturally helpful, able to work in a fast pace environment, and willing to work a problem to its successful completion.

Duties and Responsibilities:

• Work on all aspects of the practice’s billing and necessary ancillary departments.
• Work on all aspects of the billing process, including coding, claims preparation and submission, accounts receivable process and monitor both insurance and patient responsibility accounts, and collections.
• Audit activity of patient accounts, coding and billing procedures, and implement new procedures and protocols as approved by management to improve any deficiencies noted.
• Work and audit the insurance aging reports and adjustment process
• Supervise and audit insurance payments against established contract rates
• Perform regular billing and coding audits, including compliance, including audits as well as insurance and patient balance write-off processes and activity.
• Resolve patient issues or concerns, including but not limited to coordination of benefits, and account information.
• Report regularly to management and provider operational and statistical reports as requested
• Perform other control related duties, as required for efficient operations of the practice
• Perform any and all tasks assigned by executive management
• Comply with billing duties and goals

Skills and Qualification Required:

• Billing with compliance experience to Medicaid and other clearinghouses
• Strongly experience with credentialing/contracts
• Expert knowledge in coding (CPT/HCPCS, Diagnosis codes, and ICD-10 codes)
• Thorough knowledge of HIPAA and compliance rules and regulations along with OIG Guidelines
• Experience with Adjudication
• Analyze and respond to payer rejections, gathering more information as required to resubmit claims.
• Communicate with Clinical and Operational staff about implications of payer rejections
• Generate weekly and monthly reports on submitted claims and claim status
• Provide visibility through reporting to management on revenue, accounts receivable, and cash collection and triage any issues that arise.
• Effectively communicates with physicians, nurses, and other healthcare professionals to classify the services a patient has received.
• Perform follow-up actions with insurance companies to ensure timely and full payment

Job Type: Full-time

Experience:

• Healthcare (Pediatric and Family Practice) billing: 5 years (Preferred)

Job Type: Full-time

Pay: $16.25 - $22.25 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person