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$53k-71k (estimate)
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Claims and Billing Specialist
$48k-63k (estimate)
Full Time | Ancillary Healthcare
1 Month Ago
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Integrated Health Cooperative, LLC is Hiring a Claims and Billing Specialist Near Pittsburgh, PA
Integrated Health 21 (IH21) is a leading provider of worksite wellness screenings and vaccination clinics across the continental United States. Headquartered in Pittsburgh, PA with offices in Syracuse, NY and Milwaukee, WI; IH21 partners with employers and insurance companies to customize health and wellness events with the goal of improving health and wellness of their employees and insured. We are currently looking for a full-time position to work in our Corporate office in the Southside of Pittsburgh, PA.
The Claim Billing Specialist will serve as a liaison between the Data and Finance teams and is responsible for day- to-day submissions and reconciliation to ensure all medical billing claims, invoices and payments are processed in a timely manner.
RESPONSIBILITIES
- Charge entry – inputting all patient demographic and chargeable services into medical billing system.
- Prepare file and submit electronic claims to insurance carrier for payment.
- QC billing packets, track all direct bill vs insurance claims billed via outside billing vendor.
- Prepare COVID/Flu billing information to send to outside billing vendor. Record all information into Excel spreadsheet.
- Provide Finance with billing information for monthly reporting.
- Reconcile and post third–party payments – enter information into Excel spreadsheet. Provide finance with updated payment information.
- Responsible for tracking, appealing, and resolving denied claims, as well as analyzing reimbursements according to contractual agreements.
- Perform a variety of duties including claims-based accounts receivable follow-up, customer service, correspondence response, and daily reconciliation of activities.
- Works claims denial to secure payment.
- Identify trends pertaining to denied claims and meets guidelines to ensure timely and accurate reimbursement for all billed charges.
- Interact with payers and our outside billing vendor to facilitate the prompt payment of accounts receivable.
- Research, analyses and follow up on all payer edits / rejections ensuring accurate and timely claim submission.
- Assist in creating monthly invoices for services rendered for direct client billing.
- Assist data team by entering information into database / documentation platform.
- Verify accuracy of data and perform QC in accordance with company procedures.
- Work with departmental (Finance and Data) staff on matters affecting data processes and makes recommendations for improvement or enhancement to job processes to ensure standards in data entry, collection, and retrieval.
- Responsible for completing Provider Insurance Applications and ongoing credentialing.
- Responsible for maintaining provider access to insurance portals.
QUALIFICATIONS
- Degree in Health Information Management or related field, preferred
- Minimum three years related experience with medical claim billing, working with data, spreadsheets, workflow processes
- Strong analytical skills including but not limited to VLOOKUP in Excel
- Ability to work without direct supervision and willingness to take direction
- Excellent written and verbal communication skills; Problem solving skills
BENEFITS
- Health insurance plan after 30 days of full-time employment
- 100% Company paid disability and life insurance
- Voluntary life insurance
- Paid time off
- 401k Plan
Job Summary
JOB TYPE
Full Time
INDUSTRY
Ancillary Healthcare
SALARY
$48k-63k (estimate)
POST DATE
03/15/2024
EXPIRATION DATE
04/24/2024
WEBSITE
integratedhealth21.com
HEADQUARTERS
PITTSBURGH, PA
SIZE
25 - 50
FOUNDED
2008
TYPE
Private
CEO
JOHN R TOMAYKO
REVENUE
<$5M
INDUSTRY
Ancillary Healthcare
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