Benefits:
401(k)
401(k) matching
Competitive salary
Health insurance
Paid time off
Vision insurance
We are a high volume Specialty clinic located in Lancaster, CA. We are looking for a Medical Biller/AR specialist who has excellent communication skills and superb attention to detail to join our Team.
Must have previous experience in all the following areas:
Medical Insurance Eligibility
Investigate and resolve insurance denials in a professional and timely manner within contractual time limits.
Have a clear understanding of the differences in medical necessity appeals and claim appeals.
Works appeal from beginning-to-end, which includes tracking, monitoring, documenting and resolving.
Responds to insurance denials and requests for additional information with minimal direction.
Responsible for interface with management and providers as required regarding status, process and outcomes of appeals.
Prepares all appeal written documentation.
Documents all appeals in an accurate and timely manner per policy, related follow-up activities and final outcomes in designated systems while concurrently maintaining secure, comprehensive and clearly defined files.
Read and comprehend appeal and grievance correspondences and reach out to appellant and or griever to obtain additional information as needed.
·Posting charges to HMO/PPO, Medicare, Medicaid, and other payer
Submit claims to insurance companies on a daily basis
Assure the correct provider, facility, medical service and coding are billed.
Process claims Achieve maximum reimbursement for services provided.
Ensure successful entry of all medical visits into the practice management Billing System.
Reconcile all charges and data entered into the system assuring 100% data entry accuracy Proficient knowledge of CPT Codes and ICD-10 codes Process billing calls and questions from patients and third party carriers
Conduct duties in a professional and timely fashion.
Follow billing policy guidelines and documented procedures.
Demonstrated ability to exercise sound judgment.
Skills: Minimum of three years of Medical Billing. Previous experience in a medical office setting. Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems. Experience in generating CMS1500. Understanding of medical terminology and insurance laws/guidelines. Excellent organization and time management skills along with excellent oral and written communication skills. Strong team player. Ability to learn quickly. Work with minimal supervision. Strong written and verbal communication skills. Strong analytical, organizational and time management skills required. Good endurance skill, which involves the ability to work efficiently and productively in a high-pressure environment. Strong customer service and interpersonal skills. Computer literacy skills. Ability to communicate clearly and concisely. Additional responsibilities: Assist other employees with any additional work when idle. Knowledge, Skills and Abilities ICD-10/CPT knowledge. Physical Requirements: Ability to stand, sit, walk, bend and stoop for prolonged periods of time, intermittently throughout an 8 hour shift.
Performs work of equal skill, effort and responsibility as directed
May perform work of a higher level in preparation for increased responsibility
Must be willing to perform any duties asked by management or physicians
Cross trained to fill in other positions when short staffed
Knowledge of medical terminology & medical insurance.
Ability to type accurately and comfortable with computers.
Become a key contributor to the enhancement of the quality of patient care as a necessary part of a medical team.
Understand and observe legal concepts (e.g. HIPAA, confidentiality).
Multi-task efficiently and effectively as required.
Work under pressure, within time constraints.
Must be able to act calmly and effectively in a busy or stressful situation.