Medical Billing Specialist

Job description

We are seeking an energetic, hardworking, detail-oriented Billing and Collections Coordinator to provide a professional and courteous environment for our No-Fault/Workers’ Compensation & Commercial Department. The ideal candidate must have a minimum of 3 years of experience with No-Fault, Workers’ Compensation & Commercial Billing, preferably in the Durable Medical Equipment Sector.

RESPONSIBILITIES AND DUTIES

• Must have an understanding of how insurance carriers work and the ability to perform various billing and collections functions.
• Review accounts for accuracy. Obtain and verify the appropriate insured, policy, claim, and billing addresses of each payer, as well as patient eligibility, prior to billing.
• Handle all aspects of billing, including charge entry, payments, and A/R management.
• Effectively communicate with referring physicians, attorneys, insurance carriers, and patients to ensure seamless collaboration and optimal outcomes. Assertively negotiate settlements with Defense Attorneys and Insurance Adjusters. Establish payment arrangements and ensure timely payment.
• Communicate with insurance carriers regarding prior authorizations, denials, revisions, and other issues as they arise.
• Follow up on denials, incorrect or underpaid amounts, and past-due receivables promptly. Send files for reconsideration as needed.
• Directing notes that need to be completed, adjusted, and/or corrected to the Manager for revision.
• Prepare and track accounts related to arbitration and litigation.
• Posting payments and notifying Upper Management when charges are declined.
• Run weekly and monthly reports, and learn to use our billing system.
• Performing other related duties and special projects as needed.
• Follow HIPAA compliance and maintain patient privacy.

SKILLS/QUALIFICATIONS

• Possess strong knowledge of Worker’s Compensation Forms and Guidelines (C-4’s and MG-2’s).
• A clear understanding of EOB’s, CPT’s and ICD-10 codes.
• Extensive knowledge in the Workers’ Compensation Appeal Board process.
• Knowledge of Commercial/HMO insurances as well as Medicare and Medicaid.
• Knowledge of legal pleadings.
• Strong attention to detail and the ability to multitask in a fast-paced environment.
• Excellent written and verbal communication skills.
• Must be self-motivated and work with minimal supervision.
• Strong computer skills with proficiency in Microsoft Office.
• Problem-solving skills to research and resolve discrepancies. Does not take no for an answer.

We offer an excellent working environment, strong management support, and benefits. Compensation commensurate with experience.

Job Type: Full-time - In office

Salary: TBD based on experience

Benefits:

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

Schedule:

Monday to Friday 8:30am - 4:30pm

Summer Fridays: 8:30m - 4pm

Education:

High school or equivalent (Preferred)

Experience:

• ICD-10: 3 years (Preferred)
• Medical Billing: 3 years (Preferred)