Summary:

Atlantic Medical Management (AMM) is looking for a Medical Billing Specialist. AMM is a corporate medical management firm that is dedicated to improving patient care. The medical billing specialist will be responsible for transferring patient and insurance information and initiating payment processes and procedures. The ideal candidate will be well-versed in billing software, medical insurance regulations, and an expert at responding to patient and insurance inquiries. The medical biller will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into the NextGen EMR.

Essential Functions:

• Post medical charges into NextGen software in a timely manner to meet daily and monthly goals.
• Ensures payments by verifying accuracy of coding.
• Coordinate with clinics to ensure all outstanding superbills are collected prior to month end close.
• Ability to navigate around CPT, ICD-10 and HCPCS.
• Maintain in depth knowledge of all payers.
• Transfer open balances to correct insurance.
• Update patient demographic and insurance information.
• Transfer open balances to correct insurance companies.
• Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner. Knowledge of questions to ask for proper identification of a solution.
• Identify coding or billing concerns from EOB’s and work to correct the errors in a timely manner.
• Identify problem accounts and escalate as appropriate.
• Work with patients and guarantors to secure payment on outstanding account.
• Write appeals and include supporting documentation.
• Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.
• Meet set department metrics and threshold set forth by manager.
• Assist with special projects and other job-related duties as needed.
• Resolves disputed claims by gathering, verifying, and providing additional information and following up on those claims for final resolution of payment.
• Resolves discrepancies by examining and evaluating data, documentation and following corrective steps to a final resolution of payment.
• Adjusts patient bills by reviewing remittance and consulting with office.
• Prepares monthly reports of billing by summarizing billings, adjustments, and revenues received.
• Updates job knowledge by participating in educational opportunities, reading professional publications, keeping current o billing and reimbursement procedures.
• Serves and protects the practice community by adhering to professional standards, practice policies and procedures, federal, state, and local requirements, and NCQA standards.
• Accomplishes billing department and practice mission by completing related results as needed.

Minimum Qualifications:

• High School Diploma or GED.
• 3 years of medical practice billing and coding experience preferred.
• Electronic Medical Record (EMR) experience preferred including previous experience with insurance payers including Medicare, Medicaid and other commercial and private payers.
• Demonstrated well-developed interpersonal skills to interact appropriately to a complex or sensitive situation with a variety of people and personalities.
• Excellent customer service and professionalism.
• Maintains patient confidentiality.
• Proficient computer skills.
• Organized and efficient.
• Self-motivated to meet objectives.

Benefits:

• 401(k)
• Health, Dental and Vision insurance
• Employee assistance program
• AFLAC
• Paid time off

Education

• High School or GED or better