Sr. Billing Specialist

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  • As an Equal Employment Opportunity Employer, DAVIS has reporting requirements which require us to invite employees to voluntarily self-identify their race/ethnicity. Submission of this information is voluntary and refusal to provided it will not subject you to any adverse treatment. The information obtained will be kept confidential.
  • By applying to this position and providing my contact information, I give The DAVIS Companies permission to provide me with email communications and information.

Sr. Billing Specialist

  • Specialty:

    Accounting & Finance
  • Title:

    Sr. Billing Specialist
    • City:

      Boston
    • State:

      MA
    • Zip Code:

      02115
  • Start date:

    09-21-2017
  • Status:

    Closed
  • Assignment Type:

    Contract To Hire
  • Job Id:

    43492

Description

Premium Healthcare Organization looking for a Physician Medical Biller !

The Physician Medical Biller is responsible for timely and appropriate billing to and collection of monies from payors and/or patients


ESSENTIAL JOB DUTIES:
• Follows-up on all assigned accounts from within the IDX/PCS systems in accordance with pre-established goals
• Initiates proactive measures that result in account resolution
• Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect
• Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and financial class; authorization/certification/TAR information; claims address; ICD-9 and CPT-4 coding; patient insurance eligibility, patient benefit coverage; patient responsibility

• Responds timely and accurately to all incoming correspondence and inquiries from payers, patients, and other appropriate parties
• Initiates contact with patients, as necessary
• Initiates recommendations and action plans for resolving accounts
• Evaluates accounts to determine any write-offs or corrections required, including duplicate charges
• Submits claims for secondary payment
• Prepares refund requests for any monies due to patient or insurance company
• Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner
• Writes appropriate notes in IDX for every account, including any action taken
• Handles in a professional and confidential manner all correspondence, documentation, and files
• Reviews various reports to identify denials and edits; corrects claims; suggest action plans to eliminate these denials/edits in the future; determines appropriateness for appeal
• Prepares write-offs requests for denied claims which cannot be appealed
• Attempts to locate patient/guarantor through direct contact, letter, or other means
• Speaks with patient/guarantor to find third party sponsorship, settlement, or to begin charity process

• Establishes payment arrangements according to pre-set guidelines
• Prepares correspondence to patient/guarantor, as necessary
• Receives and answers inquiries or complaints concerning self-pay accounts; gathers information for timely resolution of issues
• Elevates issues, as appropriate, to the Supervisor
• Meets daily and weekly productivity standards

Requirements: 

Familiarity with computer system usage; IDX and Epic experience preferred.

Understanding of insurance billing and collection requirements.

Familiarity with CPT-4 and ICD-9 coding.

Knowledge of procedures and data flow in a healthcare organization; experience with physician billing REQUIRED.

Excellent verbal and written communication skills in the English language.

Able to work in team-oriented environment.

Some knowledge of insurance types, such as HMO, PPO, etc.;

familiarity with specialty coding; 2 or more years experience; assertiveness in collections;

1-2 years in customer service; needs minimal supervision.

 

If you are a Physician Medical Biller looking for Growth and a Great environment Apply Here!





 

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