Job description

Job Summary:

Competent level of experience in medical billing (5 years minimum.), experience in DME preferred. A background in healthcare related industry experience required. Must be knowledgeable of insurance requirements, policy guidelines, and have the ability to determine medical justification by reviewing documentation to ensure proper reimbursement. Ability to effectively operate billing software and patient portal to cover the scope of his/her job description. Ability to type over 30 WPM and navigate computer programs accurately and efficiently.

Essential Functions:
1 Assists in coordinating and maintaining the professional reimbursement program to ensure compliance with current payments, rules and legislative regulations that impact billing and collections. Assists in determining appropriate use of codes for maximizing reimbursement of services.
2 Monitors and evaluates current reimbursement/payment rules and policy guidelines to ensure that legislative and regulatory changes impacting medical billing are anticipated and communicated to the company.
3 Upon receipt, reviews delivery tickets to ensure the system accurately reflects what was provided to the patient and the billed amounts are correct. Confirms d-tickets daily to ensure inventory and other functional operating areas are not negatively affected.
4 Reviews authorization, detailed prescriptions, and verification for claims within his/her caseload, to ensure that accurate and clean claims are submitted for revenue.
5 Works towards minimizing AR within assigned caseload by correcting and resubmitting rejected claims, front end denials, and held claims.
6 Confirms and prioritizes pick-ups, exchanges, and returns on both serialized and non-serialized equipment and supplies to ensure inventory and other functional operating areas are not negatively affected.
7 Ensures that claims are submitted in a timely manner to avoid write offs.
8 Elevates trending payor and payment problems to management for global resolution.
9 Requesting adjustments, write offs, or refunds from supervisor incompliance with company standards.
10 In addition to incoming correspondence from payors; works the following reports: Daily denials, weekly stop/hold report, task queue.
11 Responds to customer inquiries both in person and electronically (phone, fax, email) as necessary, including but not limited to payments on account, questions about benefits, and questions about insurance policy.
12 Assists Cash Application Specialist with questions and inquiries related to billing activities.
13 Practices and adheres to all HIPAA, HQAA, and Compliance rules and regulations.
14 Performs other duties, as assigned by management.

Knowledge, Skill and Experience
1 Minimum Education (or substitute experience) required:
High School Diploma or GED
2 Minimum Experience Required:
5 years medical billing
3 Skills Required:
Understanding of medical terminology and extensive use of computer systems.

No or very limited exposure to physical risk.
Work is normally performed in a typical temperature controlled interior/office work environment.
No or very limited physical effort required.
Typical office environment sounds

Some examples of office equipment that will be utilized in this position are:
Computers
Monitors
Printers
Copiers
Fax Machines
Scanners
Telephones
Basic desk accessories

In addition to below this person will need to
Sitting at a desk and working on a computer.
Able to lift up to 20 pounds at times.
Able to access all areas of the facility.
Hearing, seeing, and talking are required for this position.

Job Type: Full-time

Pay: $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance
• Work from home

Schedule:

• Day shift
• Monday to Friday

Work Location: Remote

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