Benefits:

Dental insurance

Health insurance

Paid time off

Vision insurance

JOB SUMMARY:

We are seeking a Medical Biller to perform advanced-level work related to clinical denial management and AR management. The individual is responsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned. Conducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is needed. Writes and submits professionally written appeals which include compelling arguments based on clinical documentation, third-party payer medical policies, and contract language. Appeals are submitted timely and tracked through final outcome.

RESPONSIBILITIES

· Payment posting, accounts receivable follow-up, and reimbursement management

· Responsible for generating supporting documents required for insurances, Agape Pain Management and Surgery Center of Las Cruces

· Follow up on claims using various systems, i.e. practice management and clearinghouse

· Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings

· Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator. Collects and compiles accurate statistical reports.

· Other responsibilities as assigned.

JOB SPECIFICATIONS

Education:

· High school diploma or equivalent

· Higher level education preferred

Experience:

· Computer knowledge

· One year’s experience working with patient accounts in the medical field

Knowledge, Skills, and Abilities:

· Strong skills in EHR

· Possess a thorough, organized and detail-oriented approach to work

· Plan, prioritize and coordinate, multi-task and complete work assignments within deadlines.

· Able to apply effective time management and self-management skills. Able to be flexible in position requiring timely response.

· Skill in organizing resources and establishing priorities

· Strong interpersonal and communication skills (written and verbal) and the ability to work effectively with a wide range of constituencies.

· Ability to foster a cooperative business environment.

· Knowledge of insurance, authorization, billing, and denial process