Commercial Billing Representative

Description

Health Affiliates Maine has an opening for a Commercial Billing Representative to join their team. This is a full-time, 40 hr/wk, role.

Roles and Responsibilities:

• Be able to audit and process weekly commercial insurance billing as per company procedures and processes.
• Identify discrepancies in billing submissions and correct them accurately for processing
• Meet all billing and provider payment deadlines each week.
• Implement and follow all QA billing procedures according to internal and external regulations and agency standards.
• Ensure providers adhere to all agency billing policies, procedures, and processes.
• Be able to work with the State of Maine KePro Healthcare system requirements regarding the registration process and deadlines.
• Maintain accounts receivables for assigned providers.
• Communicate effectively to all providers for any issues that arise.
• Be able to process manual MaineCare Secondary claims.
• Have a full understanding of the reports in the agencies database that relate to completing day to day job functions.
• Research and correct take back and overpayments to providers and/or insurance companies accurately and in a timely manner.
• Assist with other administrative duties as deemed necessary by the management team.
• Work denials and outstanding claims that are not paid.
• Review and analyze claim denials via paper explanation of benefits, rejection management and zero pay report.
• Investigate appropriate appeal steps.
• identifies documents and communicates trends in reoccurring denials.
• Customer Service Skills: Empathy, Adaptability, Ability to Use Positive Language, Clear Communication, Self-control, Take responsponsibility and Patience. 

Benefits (Include but are not limited to the following):

We recognize that our ultimate success depends on our talented and dedicated workforce. Our goal is to provide a comprehensive benefits package that promotes work-life balance to support you doing your best work.

Highlights include:

• Extensive earned benefit time package including increase adjustments at 1 year, 5 year, 10 year and 15 year anniversaries
• Flextime and condensed work week option
• up to 11 paid Holidays
• Financial programs including Dependent Care – FSA, 401k and financial advising
• Health benefit programs including multiple medical options, onsite health coaching as well as paid life and disability insurance.

Requirements

Qualifications:

• High School Education or equivalent
• Billing Experience preferred
• Excellent Customer Service Skills required