eKidzCare is seeking a Medical Billing Collection Specialist for our office in Meadville, PA.

The candidate must be comfortable with reconciling patient collections.

Please apply if you are interested in learning a new skill and have an assertive work ethic.

JOB SUMMARY :

The Medical Billing Collection Specialist is responsible for the timely resubmission of electronic and / or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicaid Managed Care, commercial insurance payers, private pay, and school contract payers.

The ideal medical billing and collection specialist must possess critical thinking skills, an understanding of Medicaid eligibility requirements, and commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts or government regulations.

POSITION TYPE :

Full-time (Part-time & Short-term contract considered)

MAJOR DUTIES & RESPONSIBILITIES :

• Responsible for charge and payment entry within Electronic Health Records.
• Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account / claim adjudication;
• Responsible for correcting, completing, and processing claims for all payer codes;
• Analyze and interpret that claims are accurately sent to insurance companies;
• Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports;
• Process appeals online or via paper submission;
• Assist in reconciling deposit and patient collections;
• Assist with billing audit-related information;
• Process refund requests;
• Attend provider meetings / workshops when needed;
• Communicate with billing and credentialing coordinator to identify and resolve audit review issues;
• Answer / respond to correspondence related to patient accounts.
• Is available to answer billing and changes-related inquiries by patients, staff, Managed Care Organization, etc.;
• Communicate daily with internal and external customers via phone calls and written communications;
• Identify trends, and carrier issues relating to billing and reimbursements.
• Report findings to Team Lead and / or Supervisor;
• Research, record findings, and communicates effectively with Manager to achieve optimum performance;
• Pursue and participate in education to remain current with changes in the Healthcare industry;
• Perform other duties as assigned to support ePeople’s Mission, Vision, and Values.

• Proficient knowledge of PA Medicaid, Managed Care and commercial health care plan billing & collection practices, not required but preferred
• Minimum of two years of related experience in a business, medical or technical environment;
• Previous experience in a medical office setting and / or experience with an Electronic Medical Record a plus;
• Customer service driven;
• Understanding of medical terminology and insurance laws / guidelines;
• Excellent organization and time management skills along with excellent oral and written communication skills;
• Strong team player;
• Ability to learn quickly, build and maintain long-term relationships and work with minimal supervision;
• Strong written and verbal communication skills; strong analytical, organizational and time management skills required.

EDUCATION and / or EXPERIENCE :

Associate Degree preferred.

Certified Biller and Coder strongly preferred.

Pay rate is subject to change based on skills and experience*

IND7

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Last updated : 2024-05-08