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$20/hr–$25/hr
Full-time
high school
Posted 44d ago
~40 hrs/week
Remote in Texas, United States
Responsibilities
The specialist manages insurance denials by reviewing clinical documentation and writing appeals to secure correct payments. They also handle patient billing inquiries, process payments, and manage Accounts Receivable reports.
Requirements
Requires a high school diploma or GED and at least three years of experience in medical billing and claims. Proficiency with the Athena EMR system and knowledge of CPT and ICD coding are mandatory.
Full job description
Description
REMOTE - this position will be fully remote after training.Texas residents only*
Job purpose
The Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount and/or non-payment.
Duties and responsibilities
Reviews and appeal unpaid and denied claims
Attaches appropriate documents to appeal letters
Researches and evaluates insurance payments and correspondence for accuracy
Logs appeals and grievances, and tracks progress of claims
Keeps up-to-date reports and notates any trends pertaining to insurance denials
Calls insurance companies to inquire about claims, refund requests and payments
Manages Accounts Receivable reports for the Billing Department
Utilizes EMR system to submit and correct claims
Posts patient and insurance payments
Sends paper claims to insurance carriers
Answers patient billing questions
Coordinates medical and billing records payments with patients and/or third-party payers
Handles collections on unpaid accounts
Identifies and resolves patient billing complaints
Answers phone calls to the Billing Department in a timely and professional manner
Processes credit card payments over the phone and in person
Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
Operates standard office equipment (e.g. copier, personal computer, fax, etc.).
Has regular and predictable attendance
Adheres to Advanced Pain Care’s Policies and procedures
Performs other duties as assigned
Requirements
Qualifications
Education: Requires a high school diploma or GED
Experience:
Three or more years related work experience with medical billing/ claims
Previous use of Athena required
Knowledge, Skills and Abilities:
Clear and precise communication
Ability to pay close attention to detail
Effectively manages day by organizing and prioritizing
Possesses excellent phone and customer service skills and abilities
Protects patient information and maintains confidentiality
Knowledge of general medical terminology, CPT, ICD-9 and ICD-10 coding
Familiarity with analyzing electronic remittance advice and electronic fund transfers
Experience interpreting zero pays and insurance denials
Competence in answering patient questions and concerns about billing statements
Organizational skills and ability to identify, analyze and solve problems
Works well independently as well as with a team
Strong written and verbal communication skills
Interpersonal/human relations skills
Working conditions
Environmental Conditions: Medical Office environment
Physical Conditions:
Must be able to work as scheduled – typically from 8:00 – 5:00 M-F
Must be able to sit and/or stand for prolonged periods of time
Must be able to bend, stoop and stretch
Must be able to lift and move boxes and other items weighing up to 30 pounds.
Requires eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.
Related keywords
Medical BillingInsurance DenialsAthenaEMRCPTICD-9ICD-10Accounts ReceivableElectronic Remittance AdviceElectronic Fund TransfersClaims ManagementHealthcare AdministrationMedical CodingPatient BillingCollectionsPayment Posting
Advanced Pain Care is a multi-specialty clinic with Board-Certified specialists in Pain Management, Rheumatology, Neurosurgery, Neurology, Opioid Stewardship, and Behavioral Health. Pain is inevitable, but suffering is optional. With that philosophy, Advanced Pain Care helps patients understand they have the choice and the power to reclaim their lives.
Since 2002, the specialists at Advanced Pain Care have successfully relieved the suffering of thousands of patients in pain. Our team of qualified professionals believe in providing a caring and compassionate atmosphere to help improve the quality of life for those in pain.
Advanced Pain Care blankets Texas with 19 convenient locations in Bastrop, Kyle, Lockhart, South Austin, Central Austin, Georgetown, Round Rock, Cedar Park, Rockdale, Lakeway, Killeen, Lampasas, and Amarillo. In addition, our state-of-the-art outpatient surgery center facilities are dedicated to providing first-class service facilitating efficient, cost- effective care.
Every treatment offered focuses on innovation, accuracy, and minimal recovery time. APC staff are proud to be able to see patients the same or next day. We accept most insurances, letters of protection, and work with over 300 workers compensation companies.
If you are in pain, there's no need to wait. Advanced Pain Care, #ThePainStopsHere.
Offices: 2000 S. Mays St. Suite 201, Round Rock, TX 78664, US
Pain ManagementChronic PainBack PainNeck PainHeadachesHip PainPost TraumaPost-SurgeryRheumatologyBehavioral Health
Advanced Pain Care is a multi-specialty clinic with Board-Certified specialists in Pain Management, Rheumatology, Neurosurgery, Neurology, Opioid Stewardship, and Behavioral Health. Pain is inevitable, but suffering is optional. With that philosophy, Advanced Pain Care helps patients understand they have the choice and the power to reclaim their lives.
Since 2002, the specialists at Advanced Pain Care have successfully relieved the suffering of thousands of patients in pain. Our team of qualified professionals believe in providing a caring and compassionate atmosphere to help improve the quality of life for those in pain.
Advanced Pain Care blankets Texas with 19 convenient locations in Bastrop, Kyle, Lockhart, South Austin, Central Austin, Georgetown, Round Rock, Cedar Park, Rockdale, Lakeway, Killeen, Lampasas, and Amarillo. In addition, our state-of-the-art outpatient surgery center facilities are dedicated to providing first-class service facilitating efficient, cost- effective care.
Every treatment offered focuses on innovation, accuracy, and minimal recovery time. APC staff are proud to be able to see patients the same or next day. We accept most insurances, letters of protection, and work with over 300 workers compensation companies.
If you are in pain, there's no need to wait. Advanced Pain Care, #ThePainStopsHere.
Offices: 2000 S. Mays St. Suite 201, Round Rock, TX 78664, US
Pain ManagementChronic PainBack PainNeck PainHeadachesHip PainPost TraumaPost-SurgeryRheumatologyBehavioral Health