PGM Billing, LLC is seeking applicant(s) interested in full time work. Employee (s) will be responsible for supporting billing team by working insurance company medical denials. Day-to-day tasks include downloading manual denials and posting denial reasons into billing system, working denials by taking appropriate action to turn denial into payment, and communicate denial requests, details or trends to account representative.

Fulltime workers will be expected to work in the physicals office. After probationary period has passed, worker may have the option to work a combination of in-office and remote.

Duties -

- Support dedicated Account Representative in A/R follow-up and denial management.
- Follow up on unpaid claims by calling insurance carrier to challenge denials and resolve any billing discrepancies

- Noting accounts in billing system with an action taken to resolve denials
- Access insurance carrier portals or third party intermediary portals to track down denial reasons and/or payment details

- Make necessary updates to the practice management software or clearinghouse website to re-submit claims previously denied for payment
- Assign or identify appropriate CPT codes (ICD-9, DRG, ICD-10), diagnoses codes, and modifiers.
- Verify patient insurance coverage
- Maintain confidentiality of patient information and adhere to HIPAA regulations
- Stay updated on changes in medical coding systems and billing procedures

Experience:
- Minimum of 2 years of experience in medical billing or coding
- Proficiency in medical coding systems (ICD-9, DRG, ICD-10)
- Knowledge of medical office procedures and medical collection practices
- Strong attention to detail and accuracy in coding and billing processes
- Works well with others in a team setting
- Ability to work independently and meet deadlines in a fast-paced environment

Job Type: Full-time

Pay: $15.00 - $20.00 per hour

Expected hours: 35 – 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Hybrid work

Experience:

• Medical billing: 1 year (Required)

Work Location: Hybrid remote in Lyndhurst, NJ 07071