Looking for an experienced medical biller with extensive understanding of Medicaid and commercial insurance billing, credentialing, collections, denial management, payment plans, and other arrangements. The ideal candidate is compassionate, naturally helpful, able to work in a fast-paced environment, and willing to work problems to successful completion.

Work on all aspects of the practice’s billing and necessary ancillary departments. Responsibilities include coding, claims preparation and submission, accounts receivable process monitoring both insurance and patient responsibility accounts, and collections. Audit patient accounts, coding and billing procedures, and implement new procedures and protocols as approved to improve deficiencies.

Audit insurance aging reports and adjustment process; supervise and audit insurance payments against contract rates. Perform regular billing and coding audits, including compliance with billing duties and goals. Resolve patient issues or concerns including coordination of benefits and account information. Report regularly to management and providers with operational and statistical reports. Perform other control duties as required.

Required Skills and Qualifications:

Experience with Medicaid and clearinghouse billing compliance
Strong experience with credentialing/contracts
Expert knowledge of CPT/HCPCS, Diagnosis codes, ICD-10 codes
Thorough knowledge of HIPAA, OIG Guidelines, and compliance rules
Experience with adjudication and payer rejections analysis
Ability to communicate with clinical and operational staff about payer rejections
Generate weekly and monthly reports on claims status
Provide management visibility on revenue, accounts receivable, and collections
Communicate with healthcare professionals to classify patient services
Perform follow-up with insurance companies for timely payment

Senior Medical Billing and Coding Specialist