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Full-time
Posted 8d ago
~40 hrs/week
Responsibilities
The Medical Billing Specialist is responsible for processing and tracking insurance claims, managing collections, and verifying patient insurance information. They also maintain accurate patient account records and collaborate with revenue cycle managers to resolve claim denials.
Requirements
Candidates must be proficient in Microsoft Office and possess strong organizational and communication skills. The role requires compliance with legal standards, including HIPAA and the Federal False Claims Act, and the ability to manage multiple priorities effectively.
Full job description
JOB SUMMARY:
The Medical Billing Specialist is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts.
ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
Extract and verify billing information from medical records
Ensuring collection of past due balances; follow up as needed
Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies
Answer patient account inquiries; assists establish alternative payment plans when necessary
Maintain patient account records; settle third party payer issues as required
Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
Prepare and review patient statements prior to release through PMS
Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
Balance daily charges; reconcile with reports within PMS
Collaborate with revenue cycle manager and payers on denials/rejections
Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
Other duties as assigned
JOB REQUIREMENTS:
Comply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
Communicate professionally with patients and guarantors regarding balances or account information
Participate in required orientation and training programs
Cooperate with monitoring and audit functions and investigations
Participate in process improvement responsibilities
Meet productivity goals
Successful completion of required training
Handle multiple priorities effectively
REQUIRED SKILLS:
Problem solving skills to manage a variety of concrete variables
Effective verbal and written communication skills
Ability to interpret instruction presented in variety of situations
Strong organizational skills; ability to manage multiple projects simultaneously
Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
Ten key speed and accuracy
EQUAL OPPORTUNITY EMPLOYER
This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.
Our Experience is Second to None.
TruHealth’s nurse practitioners (NPs) and physician assistants (PAs) are contracted to work in skilled nursing facilities in multiple states, including Tennessee, Kansas, Oklahoma and others. Our providers expand patients’ access to care and may act as care managers for specialized Medicare Advantage health plans serving residents in long-term care communities.
Offices: 201 Jordan Rd, Franklin, Tennessee 37067, US
Our Experience is Second to None.
TruHealth’s nurse practitioners (NPs) and physician assistants (PAs) are contracted to work in skilled nursing facilities in multiple states, including Tennessee, Kansas, Oklahoma and others. Our providers expand patients’ access to care and may act as care managers for specialized Medicare Advantage health plans serving residents in long-term care communities.
Offices: 201 Jordan Rd, Franklin, Tennessee 37067, US