Reimbursement Billing Specialist

Mercy Medical Center - Canton Canton , OH 44702

Posted 4 months ago

Responsibilities: # Collection of insurance receivables # Review reimbursement received from Medicare/Medicaid, Managed Care and Commercial companies # File appeals on denied and/or rejected claims



Requirements:


High School graduate or equivalent required # Degree and/or certificate of completion in a medical insurance billing preferred # Knowledge of ICD-10 coding required # Working knowledge of HCFA-1500 billing and UB-04 billing required # Previous experience working with Medicare/Medicaid, Managed Care contractual payments denials and rejections preferred # Working knowledge of Microsoft Excel preferred # Typing speed of min. 40 wpm in addition to data entry experience


1-2 years of experience collecting insurance receivable # # Ability to professional work independently or closely in a team setting, with other departments, physician offices and insurance companies # Ability to make complex decisions and take appropriate actions # Ability to work with little to no supervision # Ability to adapt quickly to change


Responsibilities:

  • Collection of insurance receivables

  • Review reimbursement received from Medicare/Medicaid, Managed Care and Commercial companies

  • File appeals on denied and/or rejected claims

Requirements:

  • High School graduate or equivalent required

  • Degree and/or certificate of completion in a medical insurance billing preferred

  • Knowledge of ICD-10 coding required

  • Working knowledge of HCFA-1500 billing and UB-04 billing required

  • Previous experience working with Medicare/Medicaid, Managed Care contractual payments denials and rejections preferred

  • Working knowledge of Microsoft Excel preferred

  • Typing speed of min. 40 wpm in addition to data entry experience
    1-2 years of experience collecting insurance receivable

  • Ability to professional work independently or closely in a team setting, with other departments, physician offices and insurance companies

  • Ability to make complex decisions and take appropriate actions

  • Ability to work with little to no supervision

  • Ability to adapt quickly to change

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Billing Specialist

Planned Parenthood Of Greater Ohio

Posted 2 months ago

VIEW JOBS 6/29/2019 12:00:00 AM 2019-09-27T00:00 ABOUT PLANNED PARENTHOOD At Planned Parenthood of Greater Ohio, you will find an organization that supports both your professional goals and your personal passions. We strive to create a workplace where you feel valued and empowered to be more than just an associate, but also a changemaker. Go to work each day feeling like what youre doing matters. Because really it does! Compensation is competitive and Planned Parenthood of Greater Ohio offers a comprehensive and flexible benefits program. It has been designed to provide you and your family valuable resources to protect and enhance your health and financial security. Why Planned Parenthood of Greater Ohio * 100 Years of providing safe accessible & affordable health care * We utilize a team centered approach to patient care * Opportunity to assist in leading the growth of our primary care services * 360 Approach Impact our communities through high quality health care, education and public policy * In This Together Bringing associates together and fostering an inclusive culture * 100,000+ Patient visits to our health centers in 2018 * A progressive health organization committed to adhering to medical standards well above national requirements * We fight every day to provide safe, high quality and affordable health care to everyone no matter what SUMMARY The Billing Specialist performs accurate submission of claims to various third party commercial insurances, Medicare and/or Medicaid. Responsible for preparation of claims, payment posting for both self-pay and insured patients, accounts receivable, answering phones and providing assistance to both internal and external customers. Knowledge of explanation of benefits, electronic remittance advice and insurance terminology required. ICD-10 coding experience preferred but not required. Applicant must have excellent inter-personal and communication skills. ESSENTIAL DUTIES AND RESPONSIBILITIES job responsibilities include but are not limited to the following. Other duties may be assigned as necessary. * Comply with all with agency protocols, policies and procedures, including any state and federal laws and regulations. * Secure sufficient coverage information to confirm with insurer dates of eligibility and outline of benefits and assists with patient requests relative to claim status, balance queries and benefits administration. * Prepares all government billing forms and invoices including Medicaid, Medicare and any other third party government funding for medical services. Manages all files and submissions in a timely fashion. Ensures rebilling as necessary. * Conduct pre-submission audits to ensure accuracy and completeness of claim coding, pricing, and coverage verification. Assist with code and error resolution. * Conducts post-receipt audits of explanation of benefits to ensure claims were processed correctly and patient benefits were administered accurately. Assist with code and error resolution. Perform all necessary follow-ups. * Maintain a positive attitude and excellent customer services skills. * Helps to establish and maintain billing policies and documentation. * Establishes coverage and submits all third party insurance billings for reimbursement of services. * Monitors and researches outstanding patient and insurance billings by investigating nonpayment and denials. * Submits statistical and reconciliation reports to the Director of Revenue Cycle, as requested. * Provide support and assist in training as needed. Identify inaccurate coding practices and report to the Director of Revenue Cycle. SUPERVISORY RESPONSIBILITIES None QUALIFICATIONS To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE LEVEL ONE: High school or GED required. Minimum 3 years of medical billing & customer service experience. Position requires an advanced knowledge of public and private insurance billing, excellent computer skills and accuracy. LANGUAGE SKILLS Level Two: Spanish speaking candidate preferred. Strong spoken and written communication skills. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. MATHEMATICAL SKILLS LEVEL TWO: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations REASONING ABILITY LEVEL TWO: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. CERTIFICATES, LICENSES, REGISTRATIONS Valid Drivers License PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee frequently is required to reach with hands and arms. The employee is occasionally required to stand, walk, talk and hear. Specific vision abilities required by this job include close vision, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Most of the work will be performed in an indoor climate controlled work environment. This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with this job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change. #LI-HW1 Planned Parenthood Of Greater Ohio Canton OH

Reimbursement Billing Specialist

Mercy Medical Center - Canton