Healthcare South Hiring for Medical Billing Claim Representative Job at Rockland, MA Full Time

Healthcare South is looking for a full time Medical Billing Specialist to join our team in the Corporate Office.

Summary of Position:

Duties may require working insurance carrier review reports, identifying problems or issues with outstanding claims and correcting these errors in a timely manner. Maintain knowledge of all contracted carriers and their requirements for claim submission and claim appeals. Knowledge of CPT and ICD-10 coding also required. Perform other diverse duties as requested or required by the immediate supervisor and/or CEO.

Essential Job Responsibilities:

1. Maintain aging and unpaid claims reports.

2. Contact carrier representative as needed.

3. Maintain filing system to ensure timely follow-up on claims.

4. Investigate and resolve patient/insurance company inquiries concerning services, billing, or fees/charges. Examine pertinent information to determine accuracy of complaints and responsibility for errors. Notify patient/insurance company and appropriate personnel of findings, adjustments, and recommendations.

5. Prepares and follows through with daily electronic claims submissions, reviews denials and distributes to appropriate staff. Reconciles and monitors daily claim file.

6. Perform billing duties utilizing specific knowledge of medical terminology and office procedures.

7. Post insurance payments accurately to patient accounts, date of service, charge and fee schedule and carrier.

8. Notify supervisor of any payments less or greater than profiles.

9. Balance at end of day by checking operator report to Explanation of Benefits and/or checks.

10. Record accurately on monthly log and make out bank deposit slips when necessary.

11. Pull off EFT information from insurance carrier from corresponding carriers, record on monthly log when deposited and posted.

12. Review EFT report for adjustment and HIPPA denial codes for any inaccuracies.

13. Attend insurance seminars when necessary.

Education and Training:

1. High school graduate and or college graduate; completion of a medical billing/coding

Certification program preferred.

Experience:

1. 2-5 years’ experience in medical billing/charge entry/medical claims review in a hospital, office or clinic setting.

2. Experience with data entry. Prefer applicant with prior medical insurance related experience including CPT/ICD 10 coding.

Performance Requirements:

Knowledge:

1. Knowledge of billing practices and office policies and procedures.

2. Knowledge of techniques for processing insurance claims.

3. CPT and ICD-10 current codes.

4. Knowledge of Microsoft word programs and basic Excel formats.

Skills:

1. Must be able to operate office equipment; computer, fax machine, copy machine, printers, telephones, and calculators.

2. Typing speed of 35 wpm with 98 percent accuracy.

Abilities:

1. Ability to follow verbal and written instructions.

2. Ability to organize workload to determine priority of duties.

3. Ability to examine reports and insurance documents for accuracy.

4. Ability to communicate effectively and work with others.

5. Ability to work in an office with stress factors of telephone calls, noise generated by computer printers and occasional talking.

Work Environment: Full time M-F (8:30-4:30 or 9-5) position is in a well-lighted office environment, possibility of partial remote work once appropriately trained. Occasional evening and weekend work.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Supplemental pay types:

• Bonus pay

COVID-19 considerations:
Healthcare South complies with all Covid-19 precautions and Covid-19 vaccines are required.

Experience:

• ICD-10: 1 year (Preferred)

Work Location: One location