Position Summary:
We are actively seeking experienced and highly motivated Medical Billing Specialist (AR and Collections) to join our dynamic team. The successful candidate will play a crucial role in managing our collection processes for TDD services. The tasks include contract analysis, reimbursement, denial management, appeals, and resolving billing-related issues with insurance companies or other responsible parties for services rendered. The ideal candidate should possess in-depth knowledge of billing and collection practices and have a strong track record in resolving complex financial situations.
Job Details:
Medical Billing Specialist (AR and Collections)
- Work from home
- Monday to Friday | 9 PM to 6 AM (Manila Time)
- US Holidays & PH Regular Holidays
Responsibilities:
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Recognize and support patients’ rights and responsibilities in the performance of job duties, while respecting their privacy and confidentiality.
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Follow up on submitted invoices to ensure prompt and timely payment, escalating issues as necessary.
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Evaluate payments/denials received for correctness and ensure they are applied accordingly.
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Identify bad debt write-offs and A/R adjustments. Initiate write-offs and adjustments in accordance with established policies and procedures.
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Detect any overpayments and/or duplicate payments and investigate and resolve accordingly.
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Process refund requests, in accordance with policies and procedures.
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Maintain contact with other departments to obtain the patient or insurance information needed for claim payment.
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Understand all procedures within regulatory mandates.
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Ensure that the collection operations are conducted in a manner that is consistent with overall department protocol and follows Federal, State, and payer regulation, guidelines, and requirements.
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Make calls to troubleshoot payment discrepancies and establish resolution.
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Document, in detail, phone calls, phone numbers, persons spoken to, and call details on a consistent basis.
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Consistently look for areas to maximize claim reimbursement.
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Resolve issues that caused a denial within 5 days of receipt of denial.
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Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
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Understand NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
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Maintain a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
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Share knowledge gained with other staff members and work as a team member.
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Interact with others in a positive, respectful, and considerate manner.
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Perform other job-related duties as assigned.
Qualifications:
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A high school diploma or general education degree (GED) equivalent.
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At least 3 years of medical billing and collections experience.
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Home Infusion experience, hospital or chemotherapy experience is required.
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Experience in calculating drug units, Intrathecal Pain Management is a plus.
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Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.
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Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
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Strong work ethic with personal qualities of integrity and credibility.
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Self-directed, detail-oriented, conscientious, organized, and able to follow through.
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Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
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Tolerance of frequent interruptions and distractions from staff and other internal support teams.
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Proficiency in Microsoft Office, including Outlook, Word, and Excel.
Originally posted on Himalayas
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