Credentialing Coordinator Sr
Billing specialist job at US Oncology Holdings Inc
Blue Ridge Cancer Care is searching for a Credentialing Coordinator Sr. to join our growing team in Blacksburg, Virginia. We have been providing community-based cancer care in Blacksburg and the surrounding communities for over 50 years. With multiple locations, a team of over 50 providers, and a partnership with The US Oncology Network, Blue Ridge Cancer Care is a great place to grow in your career.
The Credentialing Coordinator is a Monday through Friday (8:AM - 5:00PM) position with no weekend or holiday hours. This position can be hybrid and/or fully remote. Blue Ridge Cancer Care offers comprehensive benefits including health, 401(k), and a great team environment.
Responsibilities
* With limited supervision performs all tasks related to credentialing and re-credentials providers according to quality standards and company policies and procedures.
* Handles all payor enrollment and credentialing information in a strictly confidential manner.
* Supports providers through active communication of licensure expirations. Submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommend process improvements.
* Processes all enrollment related tasks, including Faculty and Physician enrollment, hospital credentialing or re-credentialing applications, review of applications and other data for accuracy and completeness; preparation and distribution of correspondence such as requests for information, verification letters, and verification of licensure/certifications.
* Maintains current provider licensure files in accurate and organized manner and enters, tracks, and updates provider payor, hospital information in the database; and provides information to hospitals and other healthcare providers as appropriate.
* Verifies initial and re-verifies existing credential statuses for reappointment, medical licensure, federal DEA registration, board certification, and malpractice insurance coverage, for facilities and physicians.
* Requests and completes hospital credentialing and privileges applications for providers.
* Obtains malpractice insurance for providers as necessary.
* Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
* Notifies government, payor, and managed care plans of physician terminations or transfers in a timely manner.
* Assists in providing documentation for Peer Review.
* Supports Network Contracting Representative/Manager in general administrative functions.
* Trains junior and practice staff with respect to credentialing contracts, policies and procedures.
* Other duties as requested or assigned.
Qualifications
Education
* High School diploma or equivalent required. Technical certification or associate's degree a plus. At least five (5) years of credential-related work experience required.
* Proficiency with computer systems and MicroSoft (Office Outlook, Word, Power Point, and Excel) required.
Certification/Licensure
* CPCS - Certified Provider Credentialing Specialist (Preferred, but not required)
Job Qualifications & Competencies
Requires thorough knowledge of managed care provider credentialing/re-credentialing principles, methods, regulations, and procedures normally acquired through a minimum of 5 years of directly related experience. Acceptable areas demonstrating experience would be direct work experience with organizations such as a CVO, MCO, HMO or Hospital Based Credentialing (MSO).
COMPETENCIES:
* Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.
* Demonstrates Adaptability: Handles Day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility.
* Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.
* Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them with minimal assistance.
* Commitment to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluates products, processes, and service against those standards; manages quality; improves efficiency while requiring minimal supervision.
PHYSICAL DEMANDS:
This position is primarily sedentary and requires the ability to remain seated at a desk for extended periods while working on a computer. The role involves frequent use of hands and fingers for typing and handling documents, as well as occasional standing, walking, and reaching. The employee must be able to communicate effectively, both verbally and in writing. Light lifting of office materials (up to 10 pounds) may be required.
Patient Care Specialist - Behavioral Health
Harrisonburg, VA jobs
City/State Harrisonburg, VA Work Shift First (Days) Sentara Rockingham Memorial -Behavioral Health is hiring a Full-Time Patient Care Specialist! As aPatient Care Specialistwith Sentara Healthcare, you will provide non-clinical support within a physician's office and ensure an excellent patient experience by performing a variety of complex administrative tasks to support patient care delivery. Primary duties include answering phones, scheduling appointments, and answering patient questions. In this role, you will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients. Click to hear Joyce tell us about a day in the life of a Patient Care Specialist with Sentara Healthcare.
Education
HS Diploma
Associate Level degree or higher in lieu of the required experience will be considered.
Experience
3 years Customer Service experience required.
1 yearexperience with Health Insurance Plans, Medical Records Data, Medical Terminology, Registration, Scheduling, or Third-Party Payers required.
Electronic Medical Record preferred.
Keywords: Patient Care Representative, Customer Service, Talroo-Allied Health, Medical Office #indeed
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Patient Care Specialist
Chesapeake, VA jobs
City/State Chesapeake, VA Work Shift First (Days) SMG Family Medicine Riverwalk in Chesapeake, VA is hiring a Patient Care Specialist! As a Patient Care Specialist with Sentara Healthcare, you will provide non-clinical support within a physician's office and ensure excellent patient experience by performing a variety of complex administrative tasks to support patient care delivery. Primary duties include answering phones, scheduling appointments, and answering patient questions. In this role, you will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients. Click to hear Joyce tell us about a day in the life of a Patient Care Specialist with Sentara Healthcare.
Education
HS Diploma
Associate Level degree or higher in lieu of the required experience will be considered.
Experience
3 years' Customer Service experience required.
1 yearexperience with Health Insurance Plans, Medical Records Data, Medical Terminology, Registration, Scheduling, or Third-Party Payers required.
Electronic Medical Record preferred.
Keywords: Patient Care Representative, Customer Service, Talroo-Allied Health, Medical Office
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Patient Care Specialist
Suffolk, VA jobs
City/State Suffolk, VA Work Shift First (Days) Sentara Medical Group Surgery Specialists Obici Office is now hiring a Full-Time Patient Care Specialist in Suffolk, VA! Hours:Monday-Friday, Dayshift. Some weekend shifts required. NO NIGHTS or HOLIDAYS!
Overview
As a Patient Care Specialist with Sentara Healthcare, you will provide non-clinical support within a physician's office and ensure an excellent patient experience by performing a variety of complex administrative tasks to support patient care delivery. Primary duties include answering phones, scheduling appointments, and answering patient questions. In this role, you will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients. Click to hear Joyce tell us about a day in the life of a Patient Care Specialist with Sentara Healthcare.
Education
HS Diploma
Associate Level degree or higher in lieu of the required experience will be considered
Experience
3 years Customer Service experience required
1 year experience with Health Insurance Plans, Medical Records Data, Medical Terminology, Registration, Scheduling, or Third Party Payers required
Keywords: Patient Care Representative, Talroo-Allied Health, Medical Office
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Patient Care Specialist
South Boston, VA jobs
City/State South Boston, VA Work Shift Rotating Sentara Urgent Care South Boston is now hiring a Flexi Patient Care Specialist based in South Boston, VA! Schedule: Clinic hours - 8:00a.m. - 8:00p.m. Monday-Friday. Saturday and Sunday, 8am-4pm. Scheduled hours and shifts may vary based on business need and candidates' availability.
Overview
As a Patient Care Specialist with Sentara Healthcare, you will provide non-clinical support within a physician's office and ensure an excellent patient experience by performing a variety of complex administrative tasks to support patient care delivery. Primary duties include answering phones, scheduling appointments, and answering patient questions. In this role, you will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients. Click to hear Joyce tell us about a day in the life of a Patient Care Specialist with Sentara Healthcare.
Education
HS Diploma
Associate Level degree or higher in lieu of the required experience will be considered
Experience
3 years Customer Service experience required
1 year experience with Health Insurance Plans, Medical Records Data, Medical Terminology, Registration, Scheduling, or Third Party Payers required
Keywords: Patient Care Representative, Talroo-Allied Health, Medical Office
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Maternity Care Authorization Specialist (Hybrid Potential)
Barberton, OH jobs
This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity.
WHAT WE OFFER
Compensation based on experience.
Faith and purpose-based career opportunity!
Fully paid health benefits
Retirement and Life Insurance
12 paid holidays PLUS birthday
Lunch is provided DAILY.
Professional Development
Paid Training
ESSENTIAL JOB FUNCTIONS
Compile, verify, and organize information according to priorities to prepare data for entry
Check for duplicate records before processing
Accurately enter medical billing information into the company's software system
Research and correct documents submitted with incomplete or inaccurate details
Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills
Review data for accuracy and completeness
Uphold the values and culture of the organization
Follow company policies, procedures, and guidelines
Verify eligibility in accordance with established policies and definitions
Identify and escalate concerns to leadership as appropriate
Maintain daily productivity standards
Demonstrate eagerness and initiative to learn and take on a variety of tasks
Support the overall mission and culture of the organization
Perform other duties as assigned by management
SKILLS & COMPETENCIES
Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management.
Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care.
EXPERIENCE REQUIREMENTS
Required: High school diploma or passage of a high school equivalency exam
Medical background preferred but not required.
Capacity to maintain confidentiality.
Ability to recognize, research and maintain accuracy.
Excellent communication skills both written and verbal.
Able to operate a PC, including working with information systems/applications.
Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access)
Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.)
About Christian Healthcare Ministries
Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
Cancer Specialist
Barberton, OH jobs
As an Advantage Care Cancer Specialist, you'll be the initial point of contact for members diagnosed with cancer. Your role involves providing emotional support, actively listening, and offering prayers as they process this difficult news. You'll walk alongside members and their families throughout their cancer journey. Additionally, you'll collaborate with various CHM departments and work closely with our nurse navigator to connect members with high-quality treatment providers at cost-effective rates.
What We Offer
Compensation based on experience.
Faith and purpose-based career opportunity!
Fully paid health benefits
Retirement and Life Insurance
12 paid holidays PLUS birthday
Lunch is provided DAILY.
Professional Development
Paid Training
Role and Responsibilities
Obtain necessary treatment details.
Assess membership level, CHM Plus, offer pertinent programs based on the membership details and the type of cancer diagnosis.
Acquire necessary documentation for a sharing determination.
Effectively communicate with the members, supervisors, team members, the nurse navigator, and various departments.
Multitask and maintain strong attention to detail.
Interact with members to understand their needs, provide information, and help throughout the sharing determination process.
Respond to member inquiries, issues, and concerns in a timely and professional manner through various communication channels, including communication with the nurse navigator, phone and/or email.
Maintain accurate and organized records of members interactions, inquiries, orders, and other relevant information in CHM's database
Collaborate with various internal teams to ensure effective communication, smooth transitions, and a seamless member experience.
Seek opportunities for process improvement, suggest enhancements to processes, and provide feedback to member experience and overall effectiveness.
Set up negotiating agreements with providers.
Bill processing of cancer related Single Case Agreements and Memorandum of Understandings.
Guide members to financial assistance program options specific to diagnosis.
Assist members to help optimize their lifetime maximum amount when limitations exist.
Qualifications
High school diploma or successful completion of a high school equivalency
Must possess excellent verbal and written communication skills to effectively interact with CHM members and team members across various channels.
Proficient PC operating routine office equipment (e.g., faxes, copy machines, printers, multi-line telephones, etc.)
Experience with medical bills preferred.
Strong analytical and problem-solving skills.
Demonstrated history of effective phone communication skills.
Obtain knowledge of CHM guidelines.
Ability to handle stressful and sensitive situations.
Knowledge of cancer related benefit programs is helpful but not required.
Note: The qualifications and responsibilities outlined above are subject to change as the needs of the organization evolve.
About Christian Healthcare Ministries
Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
Billing Coordinator - CTI Pulmonology and Thoracic Surgery (hybrid)
Chicago, IL jobs
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?
Job Description
Performs charge capture for all procedures completed in the Bronchoscopy suite. This includes:
Audit of CPT codes associated with each procedure
Confirmation of supplies used and verification of alignment with operative notes
Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed.
Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures.
Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients.
Coordinates the pre-certification process with the clinical staff as it relates to procedures in the Bronchoscopy Suite and Operating Rooms
Handles billing inquiries received via telephone or via written correspondence.
Responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients and educating staff and patients about these programs.
Conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to precertification.
Performs activities and responds to patient inquiries related to billing follow-up.
Requests necessary charge corrections.
Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed.
Provides guidance regarding clinical documentation to optimize charges and RVUs
Confirms coding accuracy based on clinical documentation and reviews common errors or misses with physicians and leadership.
The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all services rendered at all NM Corporate Health Clinics. Researches and follows- up on all outstanding accounts. Answers all calls regarding charges and claims, providing exceptional customer service to all callers. Possesses extensive knowledge of coding, billing, insurance and collections procedures and coordinates the accounts receivable functions. Performs weekly claims, monthly late bills and patient statement runs and reviews accounts to be placed with an outside collection agency.
RESPONSIBILITIES:
Department Operations
Ensures patient demographic and billing/insurance information is kept current in the computer application. Documents all patient and company contacts.
Reviews daily clinic schedules and tracks receipt of documentation to assure completeness of charge capture.
Ensures notes are is placed in systems, clearly identifying steps taken, according to established procedures.
Works with patients/clients to establish payment plans according to predetermined procedures.
Handles all incoming customer service calls in a professional and efficient manner. Provides exceptional service to all customers, guarantors, patients, internal and external contacts.
Prepares itemized bill upon request; explains charges, payments and adjustments. Produces a clear and understandable statement to individuals on any outstanding account balance.
Responsible for timely submission of accurate bills and invoices to clients, patients and insurance companies.
Ensures timely posting of all charges, payments, denials and write-offs to the appropriate account, maintaining the highest level of quality for each transaction processed within 48 hours of receipt.
Responsible for balancing each payment and adjustment batch with reconciliation report and bank account deposits after completion.
Ensures compliant follow up procedures are followed, to third party payers regarding outstanding accounts receivables.
Run outstanding A/R reports, follow-up on unpaid claims or balances with insurance companies, patients, and collection agency, as defined by department.
Perform daily systematic review of accounts receivable to ensure all accounts ready to be worked are completed.
Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation.
Denials and appeals follow-up including root cause analysis to reduce/prevent future denials.
Reviews, prepares and sends pre-collection letters as defined by department procedures.
Identifies and sends accounts to outside collection agency.
Prepares and distributes reports that are required by finance, accounting, and operations.
Handles all work in an accurate and timely manner, consistently meets or exceeds productivity standards, quality standards, department goals and deadlines established by the team.
Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
Identify opportunities for process improvement and submit to management.
Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.
Communication and Teamwork
Fosters and maintains positive relationships with the Corporate Health team, Human Resources, NM employees and physicians.
Provides courteous and prompt customer service. Answers the telephone in a courteous professional manner, directs calls and takes messages as appropriate. Checks for messages and returns calls.
Demonstrates teamwork by helping co-workers within and across departments. Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
Communicates appropriately and clearly to physicians, manager, nursing staff, front office staff, and employees. Maintains a good working relationship within the department. Organizes time and department schedule well. Demonstrates a positive attitude.
Service Excellence
Displays a friendly, approachable, professional demeanor and appearance.
Partners collaboratively with the functional areas across Northwestern Medicine in support of organizational and team objectives.
Fosters the development and maintenance of a cohesive, high-energy, collaborative, and quality-focused team.
Supports a “Safety Always” culture.
Maintaining confidentiality of employee and/or patient information.
Sensitive to time and budget constraints.
Other duties as assigned.
Qualifications
Required:
High school graduate or equivalent.
Strong Computer knowledge, data entry skills in Microsoft Excel and Word.
Thorough understanding of insurance billing procedures, ICD-10, and CPT coding.
3 years of physician office/medical billing experience.
Ability to communicate clearly and effectively, both orally and in writing, at all levels within and outside the organization.
Ability to work independently.
Preferred:
3 years of physician office/medical billing experience in Corporate Health/Occupational Health a plus.
CPC (Certified Professional Coder) or R (Registered Medical Coder) Certificate a plus.
Additional Information
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.
If we offer you a job, we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a case-by-case basis and follow all state and federal guidelines.
Benefits
We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.
Billing Coordinator - CTI Pulmonology and Thoracic Surgery (hybrid)
Chicago, IL jobs
The salary range for this position is $21.28 - $27.66 (Hourly Rate) Placement within the salary range is dependent on several factors such as relevant work experience and internal equity. For positions represented by a labor union, placement within the salary range is guided by the rules outlined in the collective bargaining agreement. We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section located at jobs.nm.org/benefits to learn more. Northwestern Medicine is powered by a community of colleagues who are purpose-driven and committed to our mission to deliver world-class care. Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation and breakthrough research with Northwestern University Feinberg School of Medicine. We recognize where you've been, and we support where you're headed. We celebrate diverse perspectives and experiences, which fuel our commitment to equity and culture of service. Grow your career with comprehensive training and development opportunities, mentorship programs, educational support and student loan repayment. Create the life you envision for yourself with flexible work options, a Reimbursable Well-Being Fund and a Total Rewards package that support your physical, mental, emotional, and financial well-being. Make a difference through volunteer opportunities we offer in local communities and drive inclusive change through our workforce-led resource groups. From discovery to delivery, come help us shape the future of medicine. Benefits: * $10,000 Tuition Reimbursement per year ($5,700 part-time) * $10,000 Student Loan Repayment ($5,000 part-time) * $1,000 Professional Development per year ($500 part-time) * $250 Wellbeing Fund per year ($125 for part-time) * Matching 401(k) * Excellent medical, dental and vision coverage * Life insurance * Annual Employee Salary Increase and Incentive Bonus * Paid time off and Holiday pay Description *
Performs charge capture for all procedures completed in the Bronchoscopy suite. This includes: * Audit of CPT codes associated with each procedure * Confirmation of supplies used and verification of alignment with operative notes * Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed. * Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures. * Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients. * Coordinates the pre-certification process with the clinical staff as it relates to procedures in the Bronchoscopy Suite and Operating Rooms * Handles billing inquiries received via telephone or via written correspondence. * Responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients and educating staff and patients about these programs. * Conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to precertification. * Performs activities and responds to patient inquiries related to billing follow-up. * Requests necessary charge corrections. * Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed. * Provides guidance regarding clinical documentation to optimize charges and RVUs * Confirms coding accuracy based on clinical documentation and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all services rendered at all NM Corporate Health Clinics. Researches and follows- up on all outstanding accounts. Answers all calls regarding charges and claims, providing exceptional customer service to all callers. Possesses extensive knowledge of coding, billing, insurance and collections procedures and coordinates the accounts receivable functions. Performs weekly claims, monthly late bills and patient statement runs and reviews accounts to be placed with an outside collection agency. RESPONSIBILITIES: Department Operations * Ensures patient demographic and billing/insurance information is kept current in the computer application. Documents all patient and company contacts. * Reviews daily clinic schedules and tracks receipt of documentation to assure completeness of charge capture. * Ensures notes are is placed in systems, clearly identifying steps taken, according to established procedures. * Works with patients/clients to establish payment plans according to predetermined procedures. * Handles all incoming customer service calls in a professional and efficient manner. Provides exceptional service to all customers, guarantors, patients, internal and external contacts. * Prepares itemized bill upon request; explains charges, payments and adjustments. Produces a clear and understandable statement to individuals on any outstanding account balance. * Responsible for timely submission of accurate bills and invoices to clients, patients and insurance companies. * Ensures timely posting of all charges, payments, denials and write-offs to the appropriate account, maintaining the highest level of quality for each transaction processed within 48 hours of receipt. * Responsible for balancing each payment and adjustment batch with reconciliation report and bank account deposits after completion. * Ensures compliant follow up procedures are followed, to third party payers regarding outstanding accounts receivables. * Run outstanding A/R reports, follow-up on unpaid claims or balances with insurance companies, patients, and collection agency, as defined by department. * Perform daily systematic review of accounts receivable to ensure all accounts ready to be worked are completed. * Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation. * Denials and appeals follow-up including root cause analysis to reduce/prevent future denials. * Reviews, prepares and sends pre-collection letters as defined by department procedures. * Identifies and sends accounts to outside collection agency. * Prepares and distributes reports that are required by finance, accounting, and operations. * Handles all work in an accurate and timely manner, consistently meets or exceeds productivity standards, quality standards, department goals and deadlines established by the team. * Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices. * Identify opportunities for process improvement and submit to management. * Demonstrate proficient use of systems and execution of processes in all areas of responsibilities. Communication and Teamwork * Fosters and maintains positive relationships with the Corporate Health team, Human Resources, NM employees and physicians. * Provides courteous and prompt customer service. Answers the telephone in a courteous professional manner, directs calls and takes messages as appropriate. Checks for messages and returns calls. * Demonstrates teamwork by helping co-workers within and across departments. Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others. * Communicates appropriately and clearly to physicians, manager, nursing staff, front office staff, and employees. Maintains a good working relationship within the department. Organizes time and department schedule well. Demonstrates a positive attitude. Service Excellence * Displays a friendly, approachable, professional demeanor and appearance. * Partners collaboratively with the functional areas across Northwestern Medicine in support of organizational and team objectives. * Fosters the development and maintenance of a cohesive, high-energy, collaborative, and quality-focused team. * Supports a "Safety Always" culture. * Maintaining confidentiality of employee and/or patient information. * Sensitive to time and budget constraints. * Other duties as assigned. Qualifications Required: * High school graduate or equivalent. * Strong Computer knowledge, data entry skills in Microsoft Excel and Word. * Thorough understanding of insurance billing procedures, ICD-10, and CPT coding. * 3 years of physician office/medical billing experience. * Ability to communicate clearly and effectively, both orally and in writing, at all levels within and outside the organization. * Ability to work independently. Preferred: * 3 years of physician office/medical billing experience in Corporate Health/Occupational Health a plus. * CPC (Certified Professional Coder) or R (Registered Medical Coder) Certificate a plus. Equal Opportunity Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. If we offer you a job, we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a case-by-case basis and follow all state and federal guidelines. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.
Federal Government Billing Specialist
Wilmington, DE jobs
Agilent is seeking a proactive and detail-oriented Federal Government Billing Specialist to join our Customer Operations Center (COpC). This position plays a key role in supporting the Order Management process by ensuring accurate and compliant billing for federal contracts. The ideal candidate will manage complex invoices in accordance with FAR, DFARS, CAS, and other agency-specific billing requirements, while maintaining operational excellence and compliance across all transactions.
Working within the COpC, this role partners closely with cross-functional teams across Agilent, including Credit and Collections, Revenue team, Sales and other COpC teams, to ensure timely and compliant billing. The Specialist will also support internal and external audits, uphold high standards of data accuracy, and contribute to continuous improvement initiatives within the Customer Operations Center.
Key Responsibilities
Prepare and submit invoices via federal platforms (WAWF, IPP, Tungsten, etc.).
Review contract terms and funding modifications for billing accuracy.
Monitor unbilled receivables and resolve holds or rejections.
Collaborate with Contracts, Project Management, Accounting, and other COpC teams.
Maintain billing documentation and support audits (DCAA, DCMA).
Assist with month-end close activities and revenue reconciliation.
Ensure compliance with federal regulations and company policies.
Provide excellent customer service to government agencies and internal teams.
Manage portal invoicing based on agency-specific requirements to prevent rework and ensure timely payment.
Act as liaison with the collections team to resolve issues and ensure billing integrity.
Additional Information
This is a complex role requiring adaptability, attention to detail, and a customer-focused mindset. You'll thrive in a fast-paced, diverse environment where ownership and collaboration are key.
Schedule: Flexibility required; occasional overtime and late hours on the last working day of each month
Qualifications
Required Qualifications
Associate's or Bachelor's degree in Accounting, Finance, or related field (or equivalent experience).
2+ years of experience in federal billing or government contract accounting.
Familiarity with FAR/DFARS and federal audit processes.
Proficiency in Microsoft Excel and ERP systems (SAP, Oracle, Deltek).
Strong communication, organizational, and time management skills.
Ability to work independently and manage multiple priorities.
Preferred Qualifications
Experience with DCAA-compliant accounting systems.
Knowledge of indirect rate structures and cost allocations.
Prior experience in a government contractor environment.
SAP/CRM experience.
Proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint, OneNote).
Additional Details
This job has a full time weekly schedule. It includes the option to work remotely. Applications for this job will be accepted until at least November 10, 2025 or until the job is no longer posted.The full-time equivalent pay range for this position is $28.27 - $44.17/hr plus eligibility for bonus, stock and benefits. Our pay ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. During the hiring process, a recruiter can share more about the specific pay range for a preferred location. Pay and benefit information by country are available at: ************************************* Agilent Technologies, Inc. is an Equal Employment Opportunity and merit-based employer that values individuals of all backgrounds at all levels. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to sex, pregnancy, race, religion or religious creed, color, gender, gender identity, gender expression, national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, registered domestic partner status, age, sexual orientation, military or veteran status, protected veteran status, or any other basis protected by federal, state, local law, ordinance, or regulation and will not be discriminated against on these bases. Agilent Technologies, Inc., is committed to creating and maintaining an inclusive in the workplace where everyone is welcome, and strives to support candidates with disabilities. If you have a disability and need assistance with any part of the application or interview process or have questions about workplace accessibility, please email job_******************* or contact ***************. For more information about equal employment opportunity protections, please visit *************************************** Required: NoShift: DayDuration: No End DateJob Function: Customer Service
Auto-ApplyHome Health Billing Specialist | Remote
Washington jobs
Remote Home Health Billing Specialist
Pay: $18-$24 per hour, DOE Schedule: Full-time
Please Note: Due to current hiring restraints, we are unable to hire candidates residing in Maine, New York, Massachusetts, Connecticut, New Hampshire, or Hawaii at this time.
About the Role
Puget Sound Home Health & Hospice is seeking an experienced Billing Specialist to join our growing team. This is a remote position with a strong preference for candidates familiar with Home Health (possibly Hospice) billing processes and experience using HCHB. If you are detail-oriented, thrive in a fast-paced environment, and have a passion for supporting quality patient care through accurate billing, we want to hear from you!
Why Work With Us?
Competitive Pay: $18-$24/hour, DOE
Remote Work: Enjoy flexibility while supporting our mission
Health Benefits: Medical, Dental, Vision first of the month following hire date
Financial Benefits: FSA, HSA, 401K with match, voluntary insurance options
Work-Life Balance: PTO, paid holidays, sick time
Additional Perks: Tuition reimbursement, employee assistance program, company-wide celebrations, and more
Supportive Culture: Inclusive team environment with room for growth
Our Culture - How We Do What We Do
We believe in creating an environment where employees feel valued, supported, and empowered to deliver exceptional care. Our approach is rooted in collaboration, respect, and continuous learning.
Core Values: CAPLICO
Customer Second (Employee First!)
Accountability
Passion for Learning
Love One Another
Intelligent Risk Taking
Celebration
Ownership
Responsibilities
Process Home Health (possibly Hospice) billing accurately and efficiently
Ensure compliance with Medicare, Medicaid, and payer regulations
Manage accounts receivable, collections, and aged accounts
Submit claims and reconcile fiscal data following GAAP standards
Prepare reports, including Medicare cost reports and bad debt summaries
Collaborate with internal teams to resolve billing issues promptly
Maintain accurate documentation and reporting for audits and compliance
Follow up on claim denials and resubmissions
Qualifications
Minimum 3 years of Home Health (or Hospice) Agency billing experience with Medicare and Medicaid
Home Care Home Base (HCHB) experience required
Strong knowledge of payer contracts and government billing regulations
Ability to work independently and meet deadlines in a remote setting
Excellent communication and organizational skills
Important Note
If your resume does not clearly show the required experience, please include a cover letter or message explaining your background. Applications without this information will not be considered.
To learn more about Puget Sound Home Health & Hospice, please visit our website at ************************
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
Auto-ApplyBilling Specialist II Hybrid
Klamath Falls, OR jobs
BILLING SPECIALIST II HYBRID
RESPONSIBLE TO: Business Office Manager
SALARY: Step Range: 12 ($40,453 annually) - 31 ($70,934 annually); Full Benefits
CLASSIFICATION: Non-Management, Regular, Full-Time
LOCATION: Hybrid - Up to 80% Remote / 20% In Office after initial year of
training period
Klamath Tribal Health & Family Services
3949 S. 6th Street, Klamath Falls, Oregon
BACKGROUND: Comprehensive
POSITION OBJECTIVE
Klamath Tribal Health & Family Services (KTHFS) is a tribally operated health facility offering direct medical, dental, pharmacy, behavioral health, and non-emergent transportation services to American Indians and Alaska Natives residing within the service delivery area. The Billing Specialist II is responsible for managing patient accounts in a complex, multi-disciplinary Business Office environment. The incumbent shall cross-train with other members of the Business Office and shall participate in all functions of the coding and billing cycle, to include: daily review of encounters, analyzing chart notes and assuring the appropriate service codes are utilized, data entry of encounter forms, posting charges into the computer system, perform claims review, claims submission, timely billing, follow-up and collection of all accounts, payment posting, claims audit and research. The incumbent shall also function as a resource for clinic providers and staff and will assist with coding and billing questions, and quality assurance activities.
MAJOR DUTIES AND RESPONSIBILITIES
1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical necessity billing guidelines are met.
2. Ensure that the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-X, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS.
3. Work with providers, nursing staff, and the business office to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate and specified ICD-X code(s) are used. Advise manager and clinicians of deficiencies to support charge capture of all billable services.
4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies.
5. Maintain compliance with billing regulations: including Medicaid , Medicare (Parts A&B, DME), and private Insurance Carriers.
6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the Master Check's & EFT's Microsoft spreadsheet, batching the checks or EFTs into NextGen and then accurately posting the payments.
7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the refunded claim in NextGen.
8. Process No-Pay EOBs by applying an adjustment and creating billing and claim follow-up notes. This includes the appeal of insurance claims that have been wrongfully paid or denied, contacting insurance companies by phone to obtain information concerning extent of benefits and/or settle unpaid claims and providing any additional information requested by insurance companies for the processing of submitted claims.
9. Record in NextGen system all claims related phone calls, correspondence, and activities related to each patient account.
10. Maintain current filing system for encounters, POs, etc., process daily incoming mail and correspondence for review, completion, and filing.
11. Communicate regularly with Patient Registration and record patient benefit effective/term date(s) into the practice management system as needed.
12. Create electronic batches to submit to the clearinghouse and reconcile with the submitted claims tracking spreadsheet including follow up on electronic claims receipt by payer. Correct any claims before archiving the file in the clearinghouse.
13. Work outstanding A/R by reviewing, rebilling, and adjusting accounts to ensure accurate and thorough billing of claims, by running reports and working on claims. Track and monitor claims processing, ensure timely follow-up for the payment of bills; Identify, and resolve all outstanding/pending claims.
14. Monitor the Business Office outlook inbox regularly and back bill any claims and/or adjust claims where applicable.
15. Run specific reports as identified below:
· To be run and worked weekly - Pending Charges Report, Unbilled and Rebilled Encounters, Paper Claims printed, Clearinghouse Reports (claims denied, outstanding claims, claims removed, claims rejected)
· Biweekly reports - Kept Appointments with No Encounters report, Aging Reports, and maintaining up to date reports making sure all old billing is addressed.
16. Establish and maintain an effective working relationship with public and private payers; identify potential problems that could cause interruptions to cash flow.
17. Participate in yearly chart audit activities for quality assurance purposes; document results in report format, as needed, for review by the Chief Medical Officer and the Chief Quality Officer.
18. Attend coding seminars, meetings, or other training opportunities to keep abreast of changes in the profession.
19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes' broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes' Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary.
SUPERVISORY CONTROLS
Work under the supervision of the Business Office Manager, who provides general instructions. Work is assigned in terms of functional/organizational objectives. The manager assists with unusual situations that do not have clear precedents.
Employees must be able to work with minimal supervision, using initiative and judgement in setting priorities to meet the demands of the workload. Work is performed within the purview of laws, and regulations. The manager will review work regularly for quality and compliance with established policies and procedures and payer guidelines.
KNOWLEDGE, SKILLS, ABILITIES
Technical knowledge, skill, and understanding of the American Medical Association developed CPT coding system to acquire, interpret, and resolve problems based on information derived from system monitoring reports to be carried over to the required billing forms.
Technical knowledge, skill, and understanding of the concepts of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-X-CM) for classification of diseases and/or procedures.
Knowledge and understanding of CDT dental coding system.
Basic knowledge and understanding of HCPCS coding.
Knowledge of mental health and alcohol and drug coding and billing is desirable.
Ability to work with minimal supervision, using initiative and judgment in setting priorities to meet the demands of the workload while adhering to the insurance rules and regulations that relate to coding and billing.
The knowledge of and/or the ability to learn the billing guidelines as they pertain to FQHC/Tribal Health Clinics.
Knowledge of established procedures required claim forms (both paper and electronic) associated with the various health insurance programs.
In-depth knowledge of Medicaid (OARs, Rulebooks).
In-depth knowledge of Medicare Part A & B billing regulations.
Knowledge of medical terminology.
Knowledge of claims review, account auditing, and quality assurance.
The ability of tracking, handling, and completing multiple projects.
Ability to communicate well (both orally and in writing) and work effectively with other employees, managers, and administrators. This person should be able to express themselves in a clear and concise manner for the purposes of correspondence, reports and instructions, as well as for obtaining and conveying information to ensure a cooperative working relationship with all staff.
Willingness to maintain expertise to keep current with changes in procedure and diagnosis coding and third-party payer reimbursement policies through continuing education.
Above average ability to work with numbers and set standards to assure proper payment and adjustment posting.
Must be dependable, thorough, accurate, well-organized and detail oriented.
Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements.
Conduct self in accordance with KTH&FS Employee Policy & Procedure Manual.
QUALIFICATIONS, EXPERIENCE, EDUCATION
Minimum Qualifications:
Failure to comply with minimum position requirements may result in termination of employment.
· REQUIRED Onsite training/working for the first year upon hire may be required. Up to 80% of remote work after training requirements are completed subject to business needs and management approval.
· REQUIRED to possess a High School Diploma or Equivalent. (
Must submit a copy of diploma or transcripts with application.)
· REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an associate's degree in medical office systems or health information management.
· REQUIRED One (1) year of medical and/or dental billing and coding experience.
Experience must be reflected in application; or submit copy of coder certification with application.
· REQUIRED Demonstrated proficiency in technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems
· REQUIRED to have Computer and/or word processor experience.
· REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime.
· REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers.
· REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters.
Preferred Qualifications:
AAPC coder certified, or AHIMA coder certified.
· Experience with NextGen or other electronic health record systems is preferred.
Indian Preference:
· Indian Preference will apply as per policy.
Must submit documentation with application to qualify for Indian Preference
.
ACKNOWLEDGEMENT
This is intended to provide an overview of the requirements of the position. It is not necessarily inclusive, and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any job requirement by the employee, is intended to create a contract of employment of any type.
APPLICATION PROCEDURE
Submit a Klamath Tribal Health & Family Services
Application for Employment
with all requirements and supporting documentation to:
Klamath Tribal Health & Family Services
ATTN: Human Resource
3949 South 6th Street
Klamath Falls, OR 97603
***************************
IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS.
Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified.
Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”.
Applications will not be returned.
Easy ApplyBilling Specialist II Hybrid
Klamath Falls, OR jobs
BILLING SPECIALIST II HYBRID
RESPONSIBLE TO: Business Office Manager
SALARY: Step Range: 12 ($40,453 annually) - 31 ($70,934 annually); Full Benefits
CLASSIFICATION: Non-Management, Regular, Full-Time
LOCATION: Hybrid - Up to 80% Remote / 20% In Office after initial year of
training period
Klamath Tribal Health & Family Services
3949 S. 6th Street, Klamath Falls, Oregon
BACKGROUND: Comprehensive
POSITION OBJECTIVE
Klamath Tribal Health & Family Services (KTHFS) is a tribally operated health facility offering direct medical, dental, pharmacy, behavioral health, and non-emergent transportation services to American Indians and Alaska Natives residing within the service delivery area. The Billing Specialist II is responsible for managing patient accounts in a complex, multi-disciplinary Business Office environment. The incumbent shall cross-train with other members of the Business Office and shall participate in all functions of the coding and billing cycle, to include: daily review of encounters, analyzing chart notes and assuring the appropriate service codes are utilized, data entry of encounter forms, posting charges into the computer system, perform claims review, claims submission, timely billing, follow-up and collection of all accounts, payment posting, claims audit and research. The incumbent shall also function as a resource for clinic providers and staff and will assist with coding and billing questions, and quality assurance activities.
MAJOR DUTIES AND RESPONSIBILITIES
1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical necessity billing guidelines are met.
2. Ensure that the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-X, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS.
3. Work with providers, nursing staff, and the business office to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate and specified ICD-X code(s) are used. Advise manager and clinicians of deficiencies to support charge capture of all billable services.
4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies.
5. Maintain compliance with billing regulations: including Medicaid , Medicare (Parts A&B, DME), and private Insurance Carriers.
6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the Master Check's & EFT's Microsoft spreadsheet, batching the checks or EFTs into NextGen and then accurately posting the payments.
7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the refunded claim in NextGen.
8. Process No-Pay EOBs by applying an adjustment and creating billing and claim follow-up notes. This includes the appeal of insurance claims that have been wrongfully paid or denied, contacting insurance companies by phone to obtain information concerning extent of benefits and/or settle unpaid claims and providing any additional information requested by insurance companies for the processing of submitted claims.
9. Record in NextGen system all claims related phone calls, correspondence, and activities related to each patient account.
10. Maintain current filing system for encounters, POs, etc., process daily incoming mail and correspondence for review, completion, and filing.
11. Communicate regularly with Patient Registration and record patient benefit effective/term date(s) into the practice management system as needed.
12. Create electronic batches to submit to the clearinghouse and reconcile with the submitted claims tracking spreadsheet including follow up on electronic claims receipt by payer. Correct any claims before archiving the file in the clearinghouse.
13. Work outstanding A/R by reviewing, rebilling, and adjusting accounts to ensure accurate and thorough billing of claims, by running reports and working on claims. Track and monitor claims processing, ensure timely follow-up for the payment of bills; Identify, and resolve all outstanding/pending claims.
14. Monitor the Business Office outlook inbox regularly and back bill any claims and/or adjust claims where applicable.
15. Run specific reports as identified below:
· To be run and worked weekly - Pending Charges Report, Unbilled and Rebilled Encounters, Paper Claims printed, Clearinghouse Reports (claims denied, outstanding claims, claims removed, claims rejected)
· Biweekly reports - Kept Appointments with No Encounters report, Aging Reports, and maintaining up to date reports making sure all old billing is addressed.
16. Establish and maintain an effective working relationship with public and private payers; identify potential problems that could cause interruptions to cash flow.
17. Participate in yearly chart audit activities for quality assurance purposes; document results in report format, as needed, for review by the Chief Medical Officer and the Chief Quality Officer.
18. Attend coding seminars, meetings, or other training opportunities to keep abreast of changes in the profession.
19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes' broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes' Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary.
SUPERVISORY CONTROLS
Work under the supervision of the Business Office Manager, who provides general instructions. Work is assigned in terms of functional/organizational objectives. The manager assists with unusual situations that do not have clear precedents.
Employees must be able to work with minimal supervision, using initiative and judgement in setting priorities to meet the demands of the workload. Work is performed within the purview of laws, and regulations. The manager will review work regularly for quality and compliance with established policies and procedures and payer guidelines.
KNOWLEDGE, SKILLS, ABILITIES
Technical knowledge, skill, and understanding of the American Medical Association developed CPT coding system to acquire, interpret, and resolve problems based on information derived from system monitoring reports to be carried over to the required billing forms.
Technical knowledge, skill, and understanding of the concepts of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-X-CM) for classification of diseases and/or procedures.
Knowledge and understanding of CDT dental coding system.
Basic knowledge and understanding of HCPCS coding.
Knowledge of mental health and alcohol and drug coding and billing is desirable.
Ability to work with minimal supervision, using initiative and judgment in setting priorities to meet the demands of the workload while adhering to the insurance rules and regulations that relate to coding and billing.
The knowledge of and/or the ability to learn the billing guidelines as they pertain to FQHC/Tribal Health Clinics.
Knowledge of established procedures required claim forms (both paper and electronic) associated with the various health insurance programs.
In-depth knowledge of Medicaid (OARs, Rulebooks).
In-depth knowledge of Medicare Part A & B billing regulations.
Knowledge of medical terminology.
Knowledge of claims review, account auditing, and quality assurance.
The ability of tracking, handling, and completing multiple projects.
Ability to communicate well (both orally and in writing) and work effectively with other employees, managers, and administrators. This person should be able to express themselves in a clear and concise manner for the purposes of correspondence, reports and instructions, as well as for obtaining and conveying information to ensure a cooperative working relationship with all staff.
Willingness to maintain expertise to keep current with changes in procedure and diagnosis coding and third-party payer reimbursement policies through continuing education.
Above average ability to work with numbers and set standards to assure proper payment and adjustments posting.
Must be dependable, thorough, accurate, well-organized and detail oriented.
Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements.
Conduct self in accordance with KTH&FS Employee Policy & Procedure Manual.
QUALIFICATIONS, EXPERIENCE, EDUCATION
Minimum Qualifications:
Failure to comply with minimum position requirements may result in termination of employment.
· REQUIRED Onsite training/working for the first year upon hire may be required. Up to 80% of remote work after training requirements are completed subject to business needs and management approval.
· REQUIRED to possess a High School Diploma or Equivalent. (
Must submit a copy of diploma or transcripts with application.)
· REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an associate's degree in medical office systems or health information management.
· REQUIRED One (1) year of medical and/or dental billing and coding experience.
Experience must be reflected in application; or submit copy of coder certification with application.
· REQUIRED Demonstrated proficiency in technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems
· REQUIRED to have Computer and/or word processor experience.
· REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime.
· REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers.
· REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters.
Preferred Qualifications:
· AAPC coder certified, or AHIMA coder certified.
· Experience with NextGen or other electronic health record systems is preferred.
Indian Preference:
· Indian Preference will apply as per policy.
Must submit documentation with application to qualify for Indian Preference
.
ACKNOWLEDGEMENT
This is intended to provide an overview of the requirements of the position. It is not necessarily inclusive, and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any job requirement by the employee, is intended to create a contract of employment of any type.
APPLICATION PROCEDURE
Submit a Klamath Tribal Health & Family Services
Application for Employment
with all requirements and supporting documentation to:
Klamath Tribal Health & Family Services
ATTN: Human Resource
3949 South 6th Street
Klamath Falls, OR 97603
***************************
IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS.
Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified.
Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”.
Applications will not be returned.
Requirements:
Easy ApplyBilling Specialist
Beacon, NY jobs
Job Description
Billing/Collections Specialist
Billing/Collection Agent
Full Time Billing / Collections Specialist
Full TIME BILLING/COLLECTIONS POSITION AVAILABLE IN FISHKILL, NY
LOOKING FOR A RELIABLE CANDIDATE!!!!!!!
HOURS: 8AM - 4:30PM Monday through Friday
Must be motivated and detail oriented.
Must have a strong background in Medicare, insurance and patient collections as well as all other aspects of billing.
THIS POSITION IS NOT A REMOTE POSITION, PLEASE CONSIDER CAREFULLY
EMAIL RESUME AND SALARY REQUIREMENTS
Job Type: Full-time
Pay: From $18.00 per hour - $25.00 per hour
Physical Therapy Billing Specialist, Work from Home!
Sacramento, CA jobs
Job Description
Burger Rehabilitation Systems, Inc. has provided therapy services since 1978.
We seek a Billing Specialist to join our Customer Service Center team in a work from home full-time position, Monday through Friday, 8:00 a.m. to 5:00 p.m. with a one-hour lunch.
We need someone to be local in the Sacramento, California, region.
This position requires a high school diploma or GED equivalent, required 1-3 years successful experience in Physical Therapy billing and collections, competency of Rain Tree or EMR equivalent and full knowledge of current billing policies.
Our team is solid and led by a popular Director. You may be required to come into the Folsom Office for training for a week or two, and rare, but possible, periodic Folsom meetings.
Under the general direction of the Patient Services Director, this position will be responsible for the collection of assigned clinic receivables or financial class receivables, to be determined.
Essential duties and responsibilities include the following. Other duties may be assigned.
1. Aggressively work aging's and follow through to complete resolution on all accounts. Be prepared to discuss or prepare listing of accounts over 90 days with explanations for the Patient Services Director's review. Work the highest dollar amounts first.
2. Review electronic claims denials daily to ensure timely collections. Review all paper claims prior to billing.
3. Run insurance bills including electronic claims as directed.
4. Bill secondaries and send appropriate paperwork as required for timely collections.
5. Research, reprocess and appeal claim denials and information requests.
6. Send/release statements timely as directed.
7. Prepare any needed account adjustments and non-contractual write offs for supervisor's approval.
8. Research and prepare patient refund requests on credit balances monthly and give to the Patient Services Director for review and payment.
9. Submit accounts for collections/letter service consideration to supervisor for approval.
10. Submit accounts for bad debt adjustment to supervisor for review.
11. Submit credit balances to supervisor for appropriate action by 12/31 of each year.
12. Monitor lien accounts and follow up needed in order to ensure lien limits are followed or resolved and accounts are resolved timely. Apply appropriate set-up and interest fees.
13. Assist patients in a professional and timely manner and refer any unresolved problem accounts to supervisor as needed.
14. Ensure accurate entry of all charges and patient data entry for Assisted Living billing, (if assigned).
15. Ensure complete and accurate entry of patient data in RT and TS per the deadlines set by the Patient Services Director including but not limited to the insurance, onset date for Medicare patients after charges are extracted and other pertinent information required for accurate billing and copayment collection.
16. Complete related work as assigned, including but not limited to charge entry as required.
Compensation starts at $20.00 per hour.
QUALIFICATION REQUIREMENTS: Ability to alphabetize and file efficiently, working knowledge of Microsoft EXCEL and WORD experience preferred. Ability to organize and type professional letters to customers as needed, ability to multi-task, must be able to perform 10-12 thousand key strokes per hour.
EDUCATION and/or EXPERIENCE:
High school diploma or GED equivalent. One - three years' experience plus successful experience in medical billing and collections required.
Benefits include competitive compensation, direct deposit, employee assistance programs and may include:
Retirement Benefits - 401(k) Plan
Paid Time Off (PTO)
Continuing Education
Medical, Dental and Vision
Legal Shield
Life Insurance
Long Term Disability Plans
Voluntary Insurances
ID Shield
Nationwide Pet Insurance
APPLY NOW: Click on the above link “Apply To This Job”
Interested in hearing about other Job Opportunities? Contact a member of the Burger Recruiting Team today!
P.**************
F. ************
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Our Mission Statement:
We proudly acknowledge we are in business to provide rehabilitation services that make a POSITIVE difference in the lives of our patients, their families, our staff and the community at large.
Easy ApplyPayroll & Billing Clerk (Remote)
Chicago, IL jobs
The Payroll & Billing Clerk will play a crucial role in ensuring the accuracy and efficiency of payroll and billing processes. This individual will be responsible for processing payroll with precision, adhering to regulatory requirements, and managing billing activities effectively. The ideal candidate should have extensive experience in payroll management, particularly with ADP Workforce Now, and possess a deep understanding of payroll regulations and billing procedures.
Job Responsibilities:
Payroll Processing Responsibilities:
Process biweekly payrolls accurately and in a timely manner using ADP Workforce Now.
Review and validate timecards, overtime, and deductions.
Ensure proper calculation and payment of employee wages, bonuses, commissions, etc.
Identify and recommend process improvements to enhance payroll efficiency and accuracy.
Issuance of off-cycle manual payments based on payroll procedures and State requirements.
Follows Corporate internal controls and utilizes the pre and post audits cycle checklists to maintain compliance.
Collaboration:
Work closely with HR, plants and Finance departments to ensure seamless payroll operations.
Issuance of off-cycle manual payments based on payroll procedures and State requirements.
Billing Responsibilities
Invoice Management:
Generate and issue accurate invoices for services/products rendered.
Ensure invoices are dispatched on time and in accordance with company policies.
Record Keeping:
Maintain accurate records of all billing transactions.
Prepare and analyze billing reports and statements as required.
Customer Service:
Provide exceptional support to internal customers regarding billing inquiries and issues.
Ensure customer internal satisfaction through prompt and professional communication.
Compliance and Reporting:
Ensure billing processes comply with company policies and relevant regulations.
Assist with the preparation of financial reports and audits as needed.
Applicant Location: USA ONLY
Billing Specialist I (Remote after 6 months training at Cotswold)
Charlotte, NC jobs
Job Details Cotswold - Charlotte, NC Full Time High School Diploma / GED None Day Health Care
The Billing Specialist I is responsible for incoming billing inquiries. This may include, but is not limited to, account research, payment posting and balancing, adjustments, collections, patient and insurance company phone calls and inquiries.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Answers telephone and emails promptly and courteously, responds to billing questions, following HEC policy for self-pay balances. Refers escalated inquiries to appropriate patient account representative.
Corrects faulty information and advises supervisor of patterns or trends of errors noted.
Uses available technology (Virtual Swipe, Electronic Checks, and Online) to offer patients immediate payment options and encourage timely payment of balances due.
Understands the process of the “Token” number to encourage patients to sign in on the online portal for patient payments.
Prepares requests for refunds or non-contractual adjustments for review by Refunds PAR or Business Services Manager.
Ensures that all email and voice mail messages are handled on a daily basis. If the issue cannot be resolved on the same day, employee will notify parties involved about pending status.
Processes/Research all returned mail to update the patient information in Nextgen in a timely manner for appropriate filing.
Possesses a full understanding of patient accounts workflow, adheres to all processes and participates in improving departmental problems.
Abides by the Collector on Call schedule and coordinates schedule with co-workers to maintain proper coverage for patient needs.
Performs all necessary job functions related to new technological implementations.
Has an understanding of Retina financial assistance. Obtains payments through the Chronic Disease portal, and faxes or mail claims to the other financial assistance programs such as Eylea Copay Card and Lucentis Copay Card.
Answers billing correspondence received through lockbox and through patient portal.
Research returned business office mailings for corrected addresses and updates demographics in system.
POSITION REQUIREMENTS:
Minimum Qualifications:
High school diploma or equivalent
One year of clerical medical office experience.
Ability to understand explanations of benefits (EOBs).
Preferred Qualifications:
Experience in insurance billing.
General knowledge of CPT and ICD coding.
General knowledge of medical terminology
Billing Specialist
Fishkill, NY jobs
Billing/Collections Specialist
Billing/Collection Agent
Full Time Billing / Collections Specialist
Full TIME BILLING/COLLECTIONS POSITION AVAILABLE IN FISHKILL, NY
LOOKING FOR A RELIABLE CANDIDATE!!!!!!!
HOURS: 8AM - 4:30PM Monday through Friday
Must be motivated and detail oriented.
Must have a strong background in Medicare, insurance and patient collections as well as all other aspects of billing.
THIS POSITION IS NOT A REMOTE POSITION, PLEASE CONSIDER CAREFULLY
EMAIL RESUME AND SALARY REQUIREMENTS
Job Type: Full-time
Pay: From $18.00 per hour - $25.00 per hour
Medical Billing Specialist - Massapequa, NY
Remote
Pioneering trusted medical solutions to improve the lives we touch: Convatec is a global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in Advanced Wound Care, Ostomy Care, Continence Care, and Infusion Care. With more than 10,000 colleagues, we provide our products and services in around 90 countries, united by a promise to be forever caring. Our solutions provide a range of benefits, from infection prevention and protection of at-risk skin, to improved patient outcomes and reduced care costs. Convatec's revenues in 2024 were over $2 billion. The company is a constituent of the FTSE 100 Index (LSE:CTEC). To learn more please visit ****************************
Summary
Billing & Invoicing work is focused on designing and ensuring compliance with billing and invoicing processes including:
•Information verification (e.g., ensure accuracy of billing information, negotiated terms and compliance with current legislation)
•Monitoring customer accounts (e.g., ensure payments made on time, report on overdue accounts, etc.)
•Resolving billing discrepancies (e.g., investigate and resolve billing & invoicing errors, recommend process improvements to avoid future errors, etc.)
•May include collections activities
Job Description
Requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. May require the following proficiency:
• Works under moderate supervision.
• Problems are typically of a routine nature but may at times require interpretation or deviation from standard procedures.
• Communicates information that requires some explanation or interpretation.
Key Responsibilities:
Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior to submission.
Follows up with insurance companies on unpaid or rejected claims. Resolves issues and resubmits claims.
Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations.
Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer issues in an effort to recover proper reimbursement.
Provides customer service relating to all billing inquiries and complaints. Able to explain insurance processes, benefits, and exclusions. Follows HIPAA guidelines in handling customer information.
Performs other billing duties as requested by the Billing Supervisor, Billing Manager, or Director of Billing.
Qualifications/Education:
Must have a high school diploma, college degree preferred, not required.
Six months to one year of related experience and/or training; or equivalent combination of education and experience.
Proficient in use of computers and software including, but not limited to: practice management software, word processing and spreadsheet applications.
Detail oriented with ability to multi-task.
Manages one's own time with minimal supervision.
Strong mathematics and problem-solving skills.
Seeks and shares pertinent information related to insurance or internal processes.
Communicates effectively both verbally and in writing to convey and receive information.
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Self-evaluates performance to make improvements or take corrective action. Consider the relative costs and benefits of potential actions to choose the most appropriate one.
Use equipment, facilities, and materials appropriately as needed to do certain work.
This position must commit to 9 months in the role before applying for alternative roles within the organization. Exceptions must be approved by Department leadership.
Physical Demands
Regularly required to sit, stand, walk, and occasionally bend and move about the facility.
Infrequent light physical effort required.
Occasional lifting under 10 lbs.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Conditions
Work performed in an office environment,
Special Factors
This role can be performed remotely.
Beware of scams online or from individuals claiming to represent Convatec
A formal recruitment process is required for all our opportunities prior to any offer of employment. This will include an interview confirmed by an official Convatec email address.
If you receive a suspicious approach over social media, text message, email or phone call about recruitment at Convatec, do not disclose any personal information or pay any fees whatsoever. If you're unsure, please contact us at ********************.
Equal opportunities
Convatec provides equal employment opportunities for all current employees and applicants for employment. This policy means that no one will be discriminated against because of race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, affectional or sexual orientation, gender identity, military or veteran status, genetic predisposing characteristics or any other basis prohibited by law.
Notice to Agency and Search Firm Representatives
Convatec is not accepting unsolicited resumes from agencies and/or search firms for this job posting. Resumes submitted to any Convatec employee by a third party agency and/or search firm without a valid written and signed search agreement, will become the sole property of Convatec. No fee will be paid if a candidate is hired for this position as a result of an unsolicited agency or search firm referral. Thank you.
Already a Convatec employee?
If you are an active employee at Convatec, please do not apply here. Go to the Career Worklet on your Workday home page and View "Convatec Internal Career Site - Find Jobs". Thank you!
Auto-ApplyMedical Billing Specialist
Nashville, TN jobs
Pacesetter Health is a leading growth partner for podiatry clinics throughout the country. The Company is actively partnering with growth-oriented independent podiatrists and podiatry groups across the United States. The company is backed by private equity investors.
We would love for you to join our Revenue Cycle Management team in Nashville, TN!
We offer a competitive base pay, eligibility for quarterly bonuses and an excellent benefits program. This position is eligible to work remotely.
We are seeking Medical Billing Specialist to assist with filing medical claims, processing payments, resolving denials, and AR management.
As a member of the RCM team, you will:
Scrub claims to ensure that all diagnosis codes (ICD-10-CM) and procedure codes (CPT/HCPCS) meet coding standards and comply with coding guidelines and regulations
Submit scrubbed claims to appropriate payers
Post payments, AR management, review and resolve denials and inquiries
Stay updated with the latest coding guidelines, regulations and industry changes
Maintain confidentiality and adhere to HIPAA regulations
Balance cash receipts report to all batch receipts daily
Document all follow up efforts in a clear and concise manner into the AR system
Initiate refunds if necessary
Support RCM initiatives and relevant RCM efforts
What you bring:
2 years of medical coding and billing experience required
Knowledge of anatomy, physiology, and medical terminology
EHR system experience
Strong analytical and problem-solving skills
Excellent attention to detail and highly organized
Ability to work independently and in a team environment
Effective communication skills, both written and verbal
Ability to maintain benchmarks such as production and low error rate
Benefits:
Eligible to Work Remote
Quarterly Bonus Program
Health Insurance
Dental & Vision Insurance
Flexible Spending and HSA plans
Life & Disability Insurance
401k with employer match
Paid Time Off