Meta Care

Billing Specialist

• Manage billing operations for Primary Care , Dental , and Anesthesia services.
• Utilize eClinicalWorks EMR for charge entry, claim submission, and payment reconciliation.
• Verify insurance eligibility and benefits prior to services.
• Submit claims to insurance carriers and follow up on unpaid or denied claims.
• Post payments and reconcile patient accounts accurately.
• Handle patient billing inquiries and provide clear communication regarding balances.
• Maintain compliance with HIPAA and all applicable billing regulations.
• Generate and review reports to monitor billing performance and revenue cycle metrics.

Analyst

• Support physicians and specialists within an Independent Physician Association (IPA) in achieving and maintaining compliance with the Merit-based Incentive Payment System (MIPS) and other CMS quality programs.
• Guide IPA member providers and practice staff through MIPS program requirements, updates, and performance categories.
• Conduct workflow assessments to identify compliance gaps and implement corrective actions.
• Provide support and guidance to office managers regarding MIPS data collection, validation, and submission processes for all participating providers.
• Track and analyze provider performance metrics, generating detailed reports for IPA leadership.
• Deliver training sessions, webinars, and educational materials on MIPS, MACRA, and CMS quality initiatives.
• Collaborate with office managers to help them with EHR, billing teams, and administrative staff to optimize reporting accuracy and efficiency.
• Maintain awareness of CMS policy changes and communicate relevant updates to IPA members.
• Support the onboarding of new IPA providers, ensuring they understand compliance expectations, reporting timelines, and quality benchmarks.
• Maintain provider profiles, credentialing documentation, and performance records to ensure continuous compliance readiness.
• Develop individualized provider improvement plans to enhance MIPS scores and patient care outcomes.
• Serve as a liaison between providers and IPA leadership to align compliance and quality goals with organizational growth strategies.
• Monitor provider performance trends, identify opportunities for improvement, and implement ongoing support initiatives.
• Contribute to provider retention and satisfaction through education, communication, and performance support programs.

HEDIS Analyst – MIPS

• Manage and actively participate in the end-to-end billing cycle: charge entry, claim submission, payment posting, denial management, and AR follow-up.
• Oversee billing operations for primary care and cardiology specialties, ensuring clean claims and timely reimbursements.
• Set and monitor performance metrics including: Days in Accounts Receivable (AR) First-pass resolution rate (FPRR) Denial rate and resolution time Clean claim rate Net collection rate
• Develop and implement efficient billing workflows and denial prevention strategies.
• Evaluate billing processes and make recommendations for improvements or technology enhancements.
• Collaborate with providers, office managers, and executive leadership to resolve issues and streamline communication.
• Ensure compliance with payer policies, billing regulations, and HIPAA requirements.
• Monitor payer trends, reimbursement issues, and coding updates relevant to internal medicine and cardiology.

Billing Specialist

HEDIS Analyst – MIPS

Medical Billing Specialist