Revenue Cycle Billing Specialist

Job Posting

Job Summary : Manage daily billing functions for assigned patient insurance companies. Coordinate the interaction between patients and payors to facilitate timely reimbursement. Serve as a point of contact for billing problem solving. In depth knowledge of carrier Clinical Coverage Policies (CCP) and Billing Coverage Policies (BCP).

Specific Responsibilities :

• Maintain Accounts Receivable KPI (A / R balances older than 120 days must be less than 19% of total A / R)
• Maintain Adjusted Collection Percentage KPI (Reimbursement / Collections equal to or above 97% of Expected)
• Review and resolve denied patient insurance claims
• Assist in identifying current and / or potential billing issues specific to unpaid claims
• Post and balance all activity from carrier remits to include payments, contractual adjustments, and other adjustments
• Post and balance all payments from patients
• Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked
• Correct errors on electronic error reports
• Process and print / transmit patient insurance claims, bills, and other reports
• Respond to patient account inquiries in person, by phone, or by mail; resolve problems as necessary
• Respond to inquiries from office staff regarding patient charges, diagnosis coding, and insurance coverage related issues
• Respond to inquiries from employees, payers, and patients regarding CPT and ICD-10 codes
• Maintain high level of patient confidentiality
• Ensure compliance with HIPAA regulations
• Other duties as assigned

Key Competencies :

Communication Skills : Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient's family member and appropriately enumerate information in a manner easily understood by all parties.

Decision Making : Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion.

HealthCare Knowledge : Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate.

Interpersonal Skills : Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times.

Organizational Values : Adherence to MAHEC's founding principles and incorporating them every day.

Problem Solving : Having an analytical mind and ability to work autonomously to solve complex problems that may arise.

Specified Skills :

Computer : Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required.

Foreign Language : Spanish speaking skills preferred.

Physical Demands : Not Applicable.

Supervisory Responsibilities :

Education and Experience :

Minimum Qualifications : High School Diploma or GED equivalent required.

Preferred Qualifications : One (1) year of relevant billing experience preferred in a medical office setting.

Schedule : Regular attendance on-site is an essential function of this position. Typical business hours are Monday Friday, 8 : 00 am to 5 : 00 pm (or flexed to best meet the needs of the clients and / or the Division); 40 hours per workweek; weekend, holiday, or evening coverage is occasionally required. Work hours will need to be flexible in order to respond to special work assignments, or evening activities, as requested by the team leader.

Position Compensation : $22.31 / hour

At MAHEC, we strive to equip all team members with Total Rewards (pay + benefits) to honor their service, support their health, manage their financial security, build their career, and thrive.

All MAHEC employees and learners will be required to receive the Flu vaccine or have an approved exemption.

MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer.