INSURANCE BILLING SPECIALIST-REMOTE

Remote, USA Full-time
This is a Full Time REMOTE Position Compensation Range: $25.04 to $37.56 Benefits: Medical, Dental, Life, Retirement, Paid Time Off Position Classification: Non-exempt ESSENTIAL FUNCTIONS AND BASIC DUTIES: Supervisory-Specific Performance Expectations, Duties, and Responsibilities: • N/A Position-Specific Performance Expectations, Duties, and Responsibilities: • Process and submit health insurance claims to various insurance companies in a timely and accurate manner. • Ensure claims are coded correctly in compliance with the latest medical coding and billing guidelines (CPT, ICD-10, HCPCS). Collaborate with the coding and clinical departments to resolve edits and denials. • Maintain a working knowledge of Medicare and Medicaid as well as commercial payer guidelines, and stay abreast of new policy changes. • Verify patient eligibility and coverage details before claim submission, and reconcile coverage denials when necessary. • Resolve claim edits both in the electronic medical record and in the clearinghouse to prevent denials. • Follow up with insurance companies regarding denied or underpaid claims, and submit appeals when appropriate. • Review insurance and patient credit balances and resolve them timely. • Educate patients on their billing inquiries, providing clear and accurate explanations regarding their insurance coverage and payment responsibilities. • Document all actions taken with an account in the electronic medical record (EMR). • Performs other duties as assigned. Organization-Specific Performance Expectations, Duties, and Responsibilities: • Demonstrates 100% commitment to performance in accordance with the CHOICE values of MRH and representing the organization in a positive and professional manner. • Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff, and vendors. • Adheres to MRH attire/dress code per policies and procedures. • Utilizes initiative; strives to maintain a steady level of productivity; self-motivated; and manages activity and time. • Completes annual education, training, in-service, and licensure/certification requirements; and attends departmental and organizational staff meetings or reads meeting minutes. • Maintains patient confidentiality at all times. • Reports to work on time as scheduled; completes work within designated timeframes. • Actively participates in departmental and organizational performance improvement and continuous quality improvement activities. • Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state, and federal regulations and policies. • Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, the public, and staff. QUALIFICATIONS: Minimum Requirements: • Must be at least 16 years of age (21 for driving positions with a valid driver's license). • Must be able to legally work in the United States. • Must be able to pass a background check. • Must be able to pass a drug screen and breath alcohol test (if applicable). • Must complete employee health meeting. Required Education/Licensure/Certification: • Medical billing or coding certification highly desired (CPC, CPB, RHIT, CCS, etc.). • High School Diploma or equivalent, preferred. Experience: • Two (2) years prior experience in medical billing, accounts receivable, or related field required (can substitute with a medical billing or coding certification (CPC, CPB, RHIT, CCS, etc.). • Knowledge of UB-04 and CMS-1500 claim forms, preferred. • Epic or similar EMR experience, preferred. • Prior authorization process experience, preferred. • Typing speed of a minimum of 30 WPM, preferred. • Proficiency in Excel, preferred. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Apply tot his job
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