Medical Billing Specialist

Job Description

Job Description

Our Ideal Medical Billing Specialist:

Are you detailed oriented and enjoy meeting deadlines? Have great time management and organization skills? Love solving problems? Do you feel a sense of accomplishment when completing tasks and meeting goals? Want to work for a company that has a strong mission of helping children with special needs?

Interested? If this sounds like you, please apply today!

Founded in 1995, Achieve Beyond nationally meets the needs of children by providing the highest quality of pediatric therapy and autism services. Our providers and administrative staff are dedicated to our mission of helping children and families, and we are looking for smart, innovative, and driven candidates to join our team. Achieve Beyond is centered around our culture of collaboration and support to ensure our services are of the highest quality and adhere to our strong ethical standards.

Job Summary :

Responsible for collection of all insurance and private pay payments from start of service to discharge/termination.

Essential Duties and Responsibilities:

• Review and resubmit denied claims by calling insurance companies to have claims reprocessed.
• Review, reconcile and follow up on claims which are incorrectly paid.
• Contacts insurance companies with major issues to ensure accuracy of billing for maximum payment.
• Prepare insurance letters of appeals as necessary, attaching medical documentation, referrals, prior authorizations, etc.
• Documents notes in patient's accounts
• Identify refunds, provides supporting documentation, completes refund forms and submits to supervisor
• Communicate effectively via phone & in person with carriers, patients, staff and management
• Coverage for billing department during vacancies
• Collection of Patient Balances
• Other duties as assigned by manager

Education and/or Work Experience Requirements:

• Two to five years of experience working in health care billing.
• Knowledge of Insurance rules, regulations and compliance guidelines.
• Ability to interpret CPT/HCPC/ICD-10 books.

Our Mission:

At Achieve Beyond: We believe that all children have potential. We are guided by the mission to support children with special needs to Achieve Beyond their current abilities. We are always striving for continuous improvement by setting goals and measuring performance. It is the reason we will succeed together.

Qualifications and Other Requirements:

• Medical Insurance Experience Required
• Experience handling a heavy claim volume
• Excellent interpersonal skills
• Ability to multitask and respond quickly to concerns
• Quick learner
• Strong knowledge of MS Office, Outlook and Excel
• Ability to work overtime when needed

Physical Requirements:

• Occasionally ascends/descends stairs going to, while at, or leaving work location or facilities
• Occasionally moving and/or lifting objects at work weighing up to 10 pounds.
• Must be able to remain in a stationary position for prolonged periods of time up to 90% of the workday working on a computer/electronic device.
• The ability to observe details at close range (within a few feet of the observer).
• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.

Benefits Include:

• Comprehensive medical, dental, and vision coverage, and 401 (k) with employer match
• Short- and long-term disability coverage, as well as life, flex spending, and commuter benefits
• Paid time off, sick time, and holiday pay
• Various Employee Discounts on Entertainment and Equipment
• Educational reimbursement and referral bonuses
• Structured initial training
• Monthly administrative events and so much more!

Compensation: Full time hour l y $25-30. Hours: Monday-Friday 9:00am-5:30pm and overtime as needed.