Medical Billing & Collections Specialist

This is a remote position.

Schedule:

• Full-time, flexible remote work 9am to 6pm M-F (12am-9am Manila Time)
  

Client Timezone: Pacific Time (PT)

• Call on claims’ status and payment or denial information.
  
• Pull EOBs as needed and post payments.
  
• Refer complex issues to the supervisor for review and or action.
  
• Adhere to contractual requirements of Medicare, Medicaid, and managed care plans
  
• Ensure a continuous quality improvement customer service approach by proactively identifying areas of improvement and communicating those ideas to the healthcare team.
  
• Maintains and promotes positive and professional working relationships with associates and management.
  
• Perform other insurance collections tasks, projects, & related duties, as assigned
  
• Knowledge of medical policy requirements and guidelines
  
• Medical collections experience
  
• Adept at handling sensitive and confidential situations
  
• Proficient technical (computer) skills and strong knowledge of Microsoft Word, Excel and Outlook
  
• Understanding of medical terminology and CPT, HCPC and ICD10 coding preferred
  
• Excellent communication skills, both written and verbal
  
• Familiarity with EHR Systems and Medical Records / notes
  
• Experience with gaining pre-authorizations from private insurances, Medicare, and HMOs
  
• Filing appeals with insurance on an as-needed basis
  
• Excellent grasp of technology (Online EMR system, Word, Excel, Insurance Portals, electronic claim submission)
  
• Proficiency in medical terminology, ICD-10, CPT and HCPCS coding systems (Required)
  
• Excellent communication and interpersonal skills
  
• Strong understanding of the billing process for primary care and wellness, medical terminology and coding
  
• Ability to read and extract information from a path report
  
  

Requirements

Qualifications:

• Billing experience in medical required; coding certification preferred.
  
• Five years minimum experience in medical billing is required. Thorough knowledge of medical insurance and DME billing necessary (Commercial, Medicare, HMO etc.): Obtaining GAP exceptions, authorizations, appeals, etc. Explaining benefits to patients
  
• Bilingual skills are a plus.
  
• Attention to detail, proficiency in data entry, knowledge of EOBs, and strong documentation skills are essential.
  
• Excellent organizational and time management skills.
  
• Effective communication and interpersonal skills.
  
• Strong problem-solving abilities and capability to handle billing disputes.
  

Behavioral Competencies:

• Excellent customer service skills.
  
• Strong problem-resolution capabilities.
  
• Analytical thinking and thoroughness.
  
• Good research skills and effective verbal/written communication.