Position Summary:
We are actively seeking an experienced and highly motivated Medical Billing Specialist (AR and Collections) to join our dynamic team. The successful candidate will play a crucial role in managing our collection processes for TDD services. The tasks include contract analysis, reimbursement, denial management, appeals, and resolving billing-related issues with insurance companies or other responsible parties for services rendered. The ideal candidate should possess in-depth knowledge of billing and collection practices and have a strong track record in resolving complex financial situations.
Job Details:
* Medical Billing Specialist (AR and Collections)
* Permanent work from home
* Monday to Friday | 8 PM to 5 PM CST
Responsibilities:
* Recognize and support patients’ rights and responsibilities in the performance of job duties, while respecting their privacy and confidentiality.
* Follow up on submitted invoices to ensure prompt and timely payment, escalating issues as necessary.
* Evaluate payments/denials received for correctness and ensure they are applied accordingly.
* Identify bad debt write-offs and A/R adjustments. Initiate write-offs and adjustments in accordance with established policies and procedures.
* Detect any overpayments and/or duplicate payments and investigate and resolve accordingly.
* Process refund requests, in accordance with policies and procedures.
* Maintain contact with other departments to obtain the patient or insurance information needed for claim payment.
* Understand all procedures within regulatory mandates.
* Ensure that the collection operations are conducted in a manner that is consistent with overall department protocol and follows Federal, State, and payer regulations, guidelines, and requirements.
* Make calls to troubleshoot payment discrepancies and establish resolution.
* Document, in detail, phone calls, phone numbers, persons spoken to, and call details on a consistent basis.
* Consistently look for areas to maximize claim reimbursement.
* Resolve issues that caused a denial within 5 days of receipt of denial.
* Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
* Understand NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
* Maintain a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
* Share knowledge gained with other staff members and work as a team member.
* Interact with others in a positive, respectful, and considerate manner.
* Perform other job-related duties as assigned.
Qualifications:
* A high school diploma or general education degree (GED) equivalent.
* At least 3 years of medical billing and collections experience.
* Home Infusion experience, hospital, or chemotherapy experience is a plus.
* Experience in calculating drug units and intrathecal Pain Management is a plus.
* Ability to recognize, evaluate, and exercise good judgment in solving complex situations and advising by laws and regulations.
* Excellent verbal and written communication and relationship-building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
* Strong work ethic with personal qualities of integrity and credibility.
* Self-directed, detail-oriented, conscientious, organized, and able to follow through.
* Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
* Tolerance of frequent interruptions and distractions from staff and other internal support teams.
* Proficiency in Microsoft Office, including Outlook, Word, and Excel.
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