Medical Billing

Job Description

Job Description

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

Computer knowledge

One years 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