Specialist II, Medical Billing

Teladoc Health is a global, whole person care company made up of a diverse community of people dedicated to transforming the healthcare experience. As an employee, you’re empowered to show up every day as your most authentic self and be a part of something bigger – thriving both personally and professionally. Together, let’s empower people everywhere to live their healthiest lives.

Summary of Position

The Specialist II, Medical Billing reports to the Supervisor, Revenue Cycle Billing and will be responsible for a variety of tasks requiring data analysis, knowledge of insurance and billing regulations, client, and health insurance contracts to support reimbursement and collections methodology. This individual will focus on maintaining quality of medical billing for insurance verification, claim edits and claim processing. This individual will work closely in coordination with RCM (Revenue Cycle Management) leadership to ensure billing productivity and quality metrics are met for reimbursement and AR follow up.

Essential Duties and Responsibilities

• Meet department production and quality standards
• Meet project and assignment due dates and deadlines
• Knowledge of client contracts and unique billing requirements for Teladoc Health entities
• Manage inbound calls from members / internal service partners that are related to claims adjudication issues
• Research and resolve any open requests for either insurance and/or member refunds
• Escalates claim resolution to management when necessary
• Review all patient information and postings, prior to claims submission
• Submit claims to insurance carriers
• Analyzing denials and outstanding claims to determine appropriate remediation actions to resolve root causes and reduce/eliminate denials
• Follow up to see if claims are accepted or denied
• Investigate rejected claims, denial resolution review
• Verify insurance coverage and maintain accurate member eligibility status in our database
• Help automate existing processes and learn new systems
• Maintains the privacy and security of all confidential and protected health
• information
• Uses and discloses only that information which is necessary to perform the function of the job
• Performs other duties as assigned

The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs.

Supervisory Responsibilities

No

Qualifications Expected for Position

• Associate degree preferred, or equivalent industry experience
• Minimum 2-3 years of medical billing experience
• Demonstrated ability to accurately calculate figures and reconcile accounts
• Demonstrated verbal, written and interpersonal skills, with an affinity for teamwork
• Organizational, multi-tasking and time management skills, with excellent attention to details
• Comfort and success working in a fast-paced environment with tight deadlines
• Demonstrated ability to proactively identify and resolve issues
• Experience with medical coding and billing systems
• Experience with telehealth billing preferred

Required license or credential needed to perform job: N/A

The above qualifications, knowledge, experience, and/or background are expected but not required for this role.

Work Environment                                       

                              ☐ Office           ☒  Remote                 ☐ Hybrid (Office & Remote)

Travel: ≤10%

Travel percentage reflects an estimate and is subject to change dependent on business needs.

Physical Requirements

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions.  Teladoc Health will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual in line with company policy.

About Us

Teladoc Health is the global virtual care leader, offering the only comprehensive virtual care solution spanning telehealth, expert medical, and licensed platform services. Teladoc Health serves the world's leading insurers, employers, and health systems and helps millions of people around the world resolve their healthcare needs with confidence.

Job Description Acknowledgment

This job description is a general overview of nature and level of work performed by employees with this job designati