Billing Specialist
Healthcare Outcomes Performance Co. (HOPCo)
full-time
Posted on:
Location Type: Remote
Location: Arizona • United States
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About the role
- Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
- Review and prepare claims for manual and/or electronic billing submission.
- Reviews insurance rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding rejections.
- Correct and identify billing errors and resubmit claims to insurance carriers.
- Update CAS segments on secondary electronic claims as needed.
- Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
- Verifies receipt of claim with insurance plans, determining the next appropriate action step.
- Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.
- Obtains and attaches referrals to appointments/charges.
- Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
- Identifies and communicates trends and/or potential issues to the management team.
- Follows and maintains all HOPCo policies and procedures.
Requirements
- High school diploma/GED or equivalent working knowledge preferred.
- Minimum of two to three years of experience in medical billing.
- Prior experience working on claim errors in a claims management system preferred.
- Strong knowledge of resolution to payor edit reports, and reconciliation of clearinghouse and payor acceptance reports.
- Candidates with knowledge of ANSI formatting preferred.
- Knowledge of ICD-9, ICD-10, HCPS, and CPT coding, medical terminology, Medicare reimbursement guidelines, billing practices.
- Knowledge of government regulatory requirements and commercial contracts.
- Advanced computer knowledge, including Window based programs.
Benefits
- Equal Opportunity Employer
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical billingclaims managementbilling submissionbilling error correctioninsurance eligibility verificationICD-9 codingICD-10 codingHCPCS codingCPT codingANSI formatting
Soft Skills
communicationproblem-solvingattention to detailorganizational skillstime management
Certifications
high school diplomaGED