15-20 HOURS PER WEEK ON-SITE AT BAKER REHAB GROUP'S BRAIN & BALANCE CENTER IN FREDERICK, MD

QUALIFICATIONS:

• Strong working knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, and other commercial insurance carriers billing regulations.
• Working knowledge of CPT and ICD-10 coding systems.
• Strong knowledge of medical terminology.
• Knowledge of insurance carrier payment policies, practices, and amounts.
• Ability to read and understand Explanation of Benefits (EOB's) and post to patient's accounts.
• Ability to effectively prioritize and execute tasks while under pressure.
• Experience working in a team-oriented, collaborative environment.
• Highly self-motivated and directed.
• Very strong written and verbal communication skills.
• Problem solver and able to troubleshoot independently with little supervision.

DUTIES:

• Processing / sending out daily claims to insurance companies. 
• Contact insurance companies by phone, email, fax, and written correspondence to resolve issues preventing claims from being processed correctly, including verifying benefits and eligibility dates if needed.
• Working various denials from insurances including coverage in question, medical necessity, bundling, non-covered procedures, incorrect coding, credentialing, etc.
• Communicate with staff to verify claims have been coded correctly and appeal claims that have been paid incorrectly or denied.
• Follow up on accounts when no response from the insurance carriers has been received.
• Gather information regarding other pending claims on account and check status of claims utilizing the websites for various insurance companies.
• Research, identify, and rectify any special circumstances or denial trends affecting resolution of patient account and provide the finds to the practice manager.
• Send needed medical records to insurance companies upon request. 
• Identify and create batches for necessary billing adjustments.
• Responsible to reduce aged A/R.
• Oversees A/R reporting requirements.
• Ensures all cash, A/R reconciliations and sales related adjustments are accurate and performed in a timely fashion.
• Participate in (bi-weekly/monthly) billing meetings
• Review statements and communicate the specific manner in which the claim is processed with patients.
• Run collections audit reports, call patients with overdue balances to receive a payment, or work with the patients to set up a payment plan.
• Send overdue unpaid accounts to collections agency (when applicable)
• Perform other duties as directed supervisor.

REQUIREMENTS:

• 5+ years of experience in medical billing with full scope revenue cycle management.
• Excellent communication skills.
• Calm manner and patience when working with either patients or insurers when discussing accounts.
• Excellent project management skills with an attention to both detail and the big picture of each client group.
• Knowledge of Medicare, Medicaid, and private insurance billing regulations.
• Proficient with various electronic medical record systems.
• Proficient in Excel.
• Ability to work independently and collaboratively within a team environment.
• Ability to multitask and meet deadlines.
• Excellent problem solving skills.
• Knowledge of HIPPA Guidelines/regulations
• High school diploma or equivalent is required.