Billing Specialist - Spanish Speaking

Who are we? As an innovative primary care provider, Avance Care is in the business of improving the standard of healthcare.

By offering convenient, accessible, cost-effective healthcare services, we keep our patients at the center! Job Purpose Secures revenue by ensuring timely payment of claims by insurance companies, resolving both initial rejections as well as processing errors by Avance Care payer partners and clearinghouses.

The Billing Specialists ensures maximum reimbursement to the organization by timely follow-up on all claims and has the necessary functions to bill, collect, analyze, and adjudicate billing functions for all clinical services.

Core Responsibilities : Maintains confidentiality of patient information as regard to HIPAA lawsOversee the Claim Cycle to resolution, ensuring efficiency and accuracyReviews and resolves front end rejections in Clearinghouse and Billing SoftwareResearch, address, and resolves all payer claim denials, account discrepancies and payment variancesContacts appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution.

Re-file or bill to patient as appropriateAddresses and resolves incoming phone calls from insurance companies regarding claim denials or processingResearch and collect information to submit appeals.

Follow-up on all billing related appealsProvide Medical Records and supporting documents to various insurance company websites to assist with claim resolutionsReview, file, print HCFAs and mail corrected paper claims or secondary claims to insurance companies as appropriateReview, sort and resolve daily correspondence (mail, fax, etc.

Process insurance refunds and reconciles patient accounts in billing systemRecord, analyze denial trends and suggest front-end resolutions to leaderships such as claims rules engine updates to avoid further denials for a specific reasonProvide patient support through the Avance Care email.

Communicates with patients and / or family members regarding account statusProcess patient payments over the phone, post payments to appropriate accounts and provides receiptsCollaborates with Payments / Collections Team and Outsource Call Center associates regarding patient inquiriesCollaborates with Coding Team regarding discrepancies for claim denialsAids Practice locations regarding account, insurance, or billing process inquiriesRespond to all actions and telephone encounters within 72 hoursReturn all voicemails and emails within 24 hoursCompletes audit for AR work performed by Outsource associatesUpdates individual and A / R Production spreadsheet within HealthWare dailyAccomplishes all tasks as assigned or become necessaryRun Accounts Receivable Reports through reporting tools Qualifications : High School Diploma requiredPost-secondary Certificates in related field, preferred1-2 years related experience, preferredBilingual;

Spanish / English required What are we looking for? Knowledge of insurance practicesExcellent verbal and written communicationConfidentialityStrong computer skillsGeneral Math SkillsStrong attention to detailPayer policy research and analysis skills, preferredDenial analysis and trending skills, preferredKnowledge of the HCFA 1500 claim form, preferred