Denial Specialist

Job Description

Job Description

Overview

A Medical Biller, Collection Specialist is a medical professional responsible for managing the administrative responsibilities of billing insurance and processing payments for clients. A Medical Biller & Collection specialist is also responsible for Accounts Receivables, making any corrections to resubmission of any claims. In addition, they communicate with patients about outstanding balances, collecting on behalf of their employer or provider institution as necessary to ensure the patient’s procedures are paid for by their insurance company.  In addition, Medical Biller is to be experienced with billing software and medical insurance policies

Responsibilities

• Provide excellent customer service to patients, office staff, and providers
• To confirm patient benefits and insurance eligibility.
• To follow and adhere to all regulations and guidelines set by state programs, and
• HMO / PPO, etc.
• Review charges prior to submission
• Review clearinghouse rejection reports and correct any errors and resubmit
• Ability to interpret diagnostic and procedural phrases used by healthcare providers
• into coded form by locating such codes utilizing the coding manuals or software.
• In-depth knowledge of CPT, ICD-10, and HCPCS coding.
• To transfer insurance claims and billing data to billing software.
• To update billing software with rate changes.
• To create both paper and electronic Claims for transmission.
• To follow up on late payments and initiate late payment notices to relevant parties.
• To monitor and resolve financial discrepancies.
• Runs reports weekly on accounts and monitors to keep the contents at a minimum.
• Verifies all claims and ensures edits are collected and released in a timely fashion
• Ensure that all charges are entered in a timely fashion.
• Run reports on denials and correct to resubmit claims.
• Examining patient bills for accuracy and requesting any missing information.
• Contact patients with unpaid medical bills and negotiate payment plans or settlements.
• Respond to inquiries regarding billing and account related matters.
• Maintain strict confidentiality with regard to all client information. Adheres to all HIPAA
• guidelines / regulations.
• Other duties as assigned.

Qualification and Skills :

Perks :

Join us in making a difference in our patients' lives by providing exceptional care coordination!

Job Types : Full-time

Pay : $20.00 per hour

Expected hours : No less than 40 per week

Benefits :

Schedule :

People with a criminal record are encouraged to apply

Work Location : In person

This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s).  Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.

No Third Party Agencies or Submissions Will Be Accepted.

Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP

Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.

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