Company Description:

Aquila Management Services is a Medical Billing & Coding company based in Camarillo, CA that works with multiple medical practices. We are seeking an experienced Medical Billing Specialist in an inpatient and outpatient setting to join our billing team.

Job Description:

This position is responsible for supporting the Billing Management team by posting insurance payments and completing daily Explanation of Benefits (EOB) batches in accordance with established billing and collections policies and procedures, filing all primary and secondary claims by electronic and paper methods, running all standard monthly reports, and performing follow-up with insurance tracking report as directed.

Qualifications:

• Preferred 5 years’ experience in a medical office billing department
• Experience with EMR software, preferably eClinicalWorks or Nextgen
• Knowledge of Medicare, Medi-Cal, managed care plans, HMO and PPO insurance a must
• Experience in submitting appeals and provider disputes
• Follow up on returned claims
• Strong communication skills as you will be speaking with physician’s, patients, insurance representatives, and/or medical billing staff daily
• Must maintain HIPAA standards
• Ability to work in a fast-paced environment while remaining calm and professional
• Excellent organizational skills with strong attention to detail
• Strong computer and typing skills including excel
• Ability to work with multiple priorities

Major Responsibilities:

• Post all insurance payments, contractual and non-contractual adjustments for assigned carriers by CPT code and transfer outstanding balance to secondary insurance or patient responsibility per EOB protocol.
• Close payment batches daily, reconciling individual carrier payments and EOB statements.
• Initiate processes to follow up on rejected claims as evidenced by EOBs, per EOB protocol,
• Transmit all appropriate electronic and paper claims, correct any errors on claims and re-transmit, file secondary claims as necessary.
• Discuss outstanding payment amounts with patients regarding balance owed by the insurance company and the patient.
• Post all payments, by line-item, received for physician’s professional services into EMR software system including co-payments, insurance payments, and patient payments in accordance with practice protocol with an emphasis on accuracy to ensure maximum patient satisfaction and profitability. All payment batches must be balanced in both their dollar value of payments and adjustments prior to posting.
• Review the physician’s coding at charge entry to ensure compliance with Medicare guidelines and to ensure accurate and timely reimbursement.
• Provide customer service on the telephone and in the office for all clients and authorized representatives regarding patient accounts in accordance with practice protocol. Patient calls regarding accounts receivable should be returned within one business day to ensure maximum patient satisfaction.
• Verify all demographic and insurance information in patient registration of the EMR software system at the time of charge entry to ensure accuracy, provide feedback to clients and supervisor to ensure timely reimbursement.
• Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and subordinates.
• Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
• Submit primary and secondary insurance claims electronically each day and on HCFA to ensure timely reimbursement.
• Process refunds to insurance companies and patients in accordance with client protocol.
• Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates.
• Proficiency with all facets of the EMR software system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.
• Maintain information regarding coding, insurance carriers, managed care networks and credentialing in an organized easy to reference format.
• Maintain an organized, efficient and professional work environment.
• Adhere to all practice policies related to HIPAA and Medicare Compliance.

Benefits:

• 401K after one year of employment
• Health Insurance allowance for group medical insurance including access to vision and dental
• PTO and sick time

Physical Requirements:

• Continuous sitting throughout the work shift
• Must be able to read small print
• Stooping and bending to files, supplies, mobility to complete tasks
• Repetitive movements of hands, fingers and arms for typing and/or writing during work shift
• Frequently lifts, carries or otherwise moves and positions objects weighing 10-20lbs
• Continuous use of the telephone to verbally speak to insurance companies and patients
• Must be able to handle stress
• Will view computer screens for long periods of time.

Per Federal Health Care Worker Vaccine Requirements, all employees must be fully vaccinated against COVID-19 or be approved for a valid religious or medical exemption. Anyone hired by the company must provide proof of their COVID-19 vaccine before they can begin employment or request and be approved for a valid religious or medical exemption.

Job Type: Full-time

Salary: $23.00 - $27.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• ICD-10: 3 years (Preferred)

Work Location: In person

Job Type: Full-time

Pay: $23.00 - $27.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Private practice

Work Location: In person