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. Apply tot his job
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