Role Description
The purpose of the Medical Billing Specialist role is to:
• Support our life-saving Lifeline products by using your medical billing and collecting experience to obtain maximum reimbursement while establishing strong relationships with insurance companies and customers.
Job Duties and Responsibilities
• Obtaining and entering Medicaid authorizations accurately and timely to ensure clean claims are released.
• Reviewing claims for the accuracy of procedures, diagnoses, demographic and insurance information.
• Obtaining and entering equipment upgrades and correspondence from the payer agencies.
• Reviewing and correcting all claims/charge denials and edits that are communicated via Explanation of Benefits (EOB) and other methods of communication.
• Monitoring days in Accounts Receivable and ensuring that they are maintained at the levels expected by management.
• Communicating proactively of any billing issues identified.
• Timely follow-up on billing and claims discrepancies as communicated by the payer.
• Reading and interpreting insurance Explanation of Benefits.
• Responding to inquiries from agencies, case managers, insurance companies, and internal customers in a timely manner.
• Regularly attending monthly staff meetings and in-house training events.
• Additional duties and responsibilities as required and or assigned.
Qualifications
• Associates Degree in Medical Billing and Coding or Accounting, preferred.
• 2+ years of experience in medical billing, preferably with Medicaid and Managed Care reimbursement.
• Familiarity with CPT and ICD-10 coding and medical terminology.
• Strong technical skills with Excel, software, including, but not limited to: Billing Software, MS Office, and Insurance Portals.
• High aptitude to learn new programs, system integrations, and business processes.
• Excellent customer service skills with strong written and verbal communication skills.
• Ability to manage relationships with various insurance payers and agencies.
• Strong work ethic with proven track record of accuracy, dependability and consistency.
• Must be able to think independently, multitask, have strong problem-solving skills, and have a continuous improvement mentality.
• Ability to gain the cooperation of others in pursuit of company goals.
Requirements
• Connect America/Lifeline is a drug-free workplace and an Equal Opportunity Employer.
• We participate in the E-Verify program in our hiring practices to achieve a lawful workforce.
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