Senior Medical Billing Specialist
Job Requirements/Task Summary
- 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.
- Initiate appeals to payers following the guidelines outlined for that payer. Note account and track appeal to resolution.
- 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.
- 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.
- 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
- GE Centricity Practice Solutions
- EClinical Works
- CPa Medical Billing & Consulting is offering a competitive salary plus bonus and a full benefit package including health, dental, 401k, paid holidays and vacation.
- 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.
- 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.
- Certified professional coder preferred but not required.
- College degree preferred but not required.
- 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.
- CPa Medical Billing & Consulting is offering a competitive salary plus bonus and a full benefit package including 401k, paid holidays and vacation.
- CPa Medical Billing & Consulting is located in Branford, CT – about .5 mile off exit 55/I-95.