Billing Specialist $16.00
ROLE AND RESPONSIBILITIES OF THE CARE TEAM
The Medical Specialist is responsible to all relevant billing but not limited to: claim reimbursement requirements involving claim submission, charges, patient refunds, insurance refunds, denials, EOBs, Write Offs, adjustments transactions.
• Daily posting a variety of patient charges; posting payments received from patients, Medicare, Managed Care Plans, Commercial Insurances, and other health insurance carriers; preparing billing adjustments and/or re-billing; preparing and maintaining daily productivity reports; and preparing, completing, and analyzing batch control reports.
• Entering on a timely basis all charges, payments, credits, and adjustments.
• Reviewing patients’ encounter forms to ensure accuracy and completeness prior to performing charge entry transaction; taking the necessary action to correct the encounter form by contacting the provider of services, medical records department, 3rd party insurance carrier, or the patient.
• Identifying missing codes to meet MRA revalidation requirements based on documentation.
• Reviewing and completing claim batches, making necessary corrections, assigning batch control numbers and entry dates; computing the number of transactions, total charges, credits, payments, and overall batch totals.
• Reviewing the daily batch proof listing which shows the previous day’s charge entries; verifying individual productivity, denials, rejections as well as accuracy of data entered.
• Follow-up on insurances denials or incorrect payment.
• Follow-up Insurance A/Rs as well as Patient A/R’s.
• Ensure all HEDIS CPTs and ICD9s codes are entered, documented and submitted to Medicare and Managed Care plans.
• Perform Appeals and Re-considerations.
• Generate Monthly Productivity Reports and Reviews them with VP of Operations.
• Certified Professional Coder preferred.
• 5 Years or more in Medical Billing
• 3 Years in Primary Care Billing
• Understanding of HEDIS and billing requirements for HEDIS
• Excellent Organizational skills and attention to detail.
• Excellent Written and Verbal Skills
Qualified candidates should submit/upload their resume information via http://imamedicalgroup.com/ima-job-opportunities/ - mention CFEC.org Job Posting.