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Senior Medical Billing Specialist

Job Requirements/Task Summary

Research:

  • Work aged accounts on assigned payers prioritizing accounts that are approaching timely filing denial.
  • Devote time weekly to work current rejections 1 to 90 days old. Fix errors and re-bill accordingly.
  • Look up payer eligibility using payer websites or call payers to gather needed information for billing. Update all accounts in the system for that patient and promptly re-bill.
  • Contact guarantors as needed to determine insurance coverage.

Appeals:

  • Initiate appeals to payers following the guidelines outlined for that payer. Note account and track appeal to resolution.

Accountability:

  • Enter notes on all tickets with action taken and paste any proof of insurance eligibility.
  • Be prepared to account for action taken on tickets. Participate in meetings as instructed by management.
  • Provide work status updates to management upon request that may including running statistical reports.
  • Meet all established deadlines and assignment goals at all time.
  • Promptly inform management of any problems or changes with system or payers identified during the course of daily work.

Personal Development:

  • Participate in personal development training and cross training as instructed by management.
  • Understand and follow all payer rules when setting up billing schemes on accounts to ensure accurate claims.
  • Understand coding rules and schemes to detect potential claim errors. Consult with supervisor on those accounts in question.

Office Policies:

  • Adhere to all office policies at all times.
  • Maintain confidentiality at all times.
  • Work special projects as assigned.
  • Participate in being “part of the team” – contribute to a calm but enjoyable work place environment

Computer Systems

  • GE Centricity Practice Solutions
  • EClinical Works
  • EPIC

Compensation

  • CPa Medical Billing & Consulting is offering a competitive salary plus bonus and a full benefit package including health, dental, 401k, paid holidays and vacation.

Location

  • CPa Medical Billing & Consulting is located in Branford, CT – about 0.2 miles off exit 55/I-95.
Billing Account Manager
Under the direction of the CEO, you will be responsible for the management of our medical provider clients. This is a hands on position.

Experience

  • MUST HAVE at least 10 years billing experience with at least 5 years of supervisory experience.
  • GE Centricity or EClinical Works billing software experience is preferred but not required.

Overview of responsibilities

  • Write and maintain process documentation which clearly specifies client responsibilities
  • Weekly Account Manager meetings and present updates for each assigned client including direct client feedback, billing and collections performance.
  • Maintain minutes and track action items with estimate completion dates and responsible party for each.
  • Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
  • Meets department standards by contributing information to strategic plans; meets production, productivity, quality, and customer-service standards; resolving problems; identifying system improvements.
  • Analysis of denial and AR to identify variances from expected collections; Implementing corrective actions to prevent denials and maximize reimbursement of claims.
  • Prepares monthly management reports per client and sets up meeting to review reports, performance, updates and issues.
  • Communicating with Insurance representatives at all levels to resolve issues affecting collections; expediting the handling of any barriers to collections.
  • Decreasing the Days in AR to the minimum obtainable number
  • Review all appeals created by team prior to mailing and send feedback as needed to maximize effectiveness.
  • Maintaining the AR as low as possible by promoting collection of payable claims as quickly as possible.
  • Handle any credentialing requirements from a client or re-credentialing from an insurance.

Education

  • Certified professional coder preferred but not required.
  • College degree preferred but not required.

Attributes

  • Strong attention to detail and expertise with ICD-9, CPT-4 coding, HCFA, UB04 and EDI.
  • A team player with the ability to multi-task and prioritize, excellent communication, delegating, interpersonal and problem solving skills.
  • Advanced understating with carriers claim guidelines and EOB’s.

Compensation

  • CPa Medical Billing & Consulting is offering a competitive salary plus bonus and a full benefit package including 401k, paid holidays and vacation.

Location

  • CPa Medical Billing & Consulting is located in Branford, CT – about .5 mile off exit 55/I-95.