Billing Specialist II

🕒 3 dias atrás

🏈 Alabama, Florida, +6 estados a mais – Remoto

🏈 Alabama – Remote 🐊 Florida – Remote 🏖️ New Jersey – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote

💵 $25 - $29 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

📊 Especialista em Faturamento

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Clearway Pain Solutions

SiteLinkedInTodas as Vagas

201 - 500 funcionários

🧘 Bem-estar

💊 Farmacêutico

Healthcare • Wellness • Pharmaceuticals

A Clearway Pain Solutions é uma organização de saúde dedicada a fornecer serviços abrangentes de gerenciamento da dor. Com unidades localizadas em vários estados, incluindo o Texas, a empresa se concentra em aliviar a dor crônica, restaurar a função física e melhorar a qualidade de vida de seus pacientes. A Clearway adota uma abordagem multidisciplinar no tratamento, oferecendo gerenciamento intervencionista da dor, fisioterapia e administração de medicamentos, garantindo que os pacientes recebam um cuidado personalizado que atenda às suas necessidades únicas.

Descrição

• Supports the complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system. • Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues. • Actively follows up on outstanding complex claims/or charges. • Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions. • Assists the auditor in reviewing notes for medical necessity. • Works with the authorization department to resolve authorization issues with complex procedures. • Runs and maintains tracking logs to track complex high dollar procedures and report the results to the billing department management team. • Contacts the various Provider Service Representatives to resolve repetitive payment issues. • Acts as a resource for the Billing Staff for complex issues. • Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days. • Processes daily correspondence, claim status, handles denials, appeals, and re-bills. • Answers billing questions and inquiries from patients and internal staff. • Updates patient files with address changes, contact information changes, etc., as needed. • Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes. • Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc. • Keeps supervisor apprised of matters regarding accounts receivable. • Responds to requests from the billing company in a timely fashion. • Researches denials and submits correct claims/medical documentation. • Reviews and manages claims within the work dashboard hold buckets for resolution. • Creates, maintains, and updates reports, as directed. • Exercises confidentiality in all areas, abiding by HIPAA rules and regulations. • Helps train new revenue cycle staff. • Collects and reviews end of day reports. • Checks work e-mail on a regular basis throughout the workday. • Participates in and completes all required trainings and in-services. • Performs other duties as assigned.

🎯 Requisitos

• High School Diploma, or equivalent WITH a minimum of five (5) years related experience; OR an equivalent combination of education and/or experience. • Must have knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook). • Must have excellent written and oral communication skills, including exceptional customer service. • Must be able to establish and maintain effective working relationships with doctors, clinical staff, other co-workers and the public. • Must be able to work individually as well as within a team. • Must be able to follow both verbal and written instructions. • Must be able to work a flexible schedule. • Must be able to respond with patience and understanding during stressful conditions related to patient health and emergent situations. • Must be able to multi-task and prioritize. • Must demonstrate extreme attention to detail. • Must possess strong organization skills. • Must be able to problem solve and use reasoning. • Must be able to meet predefined quality standards. • Must maintain and project a professional attitude and appearance at all time. • Must have a working knowledge of CPT and ICD-10 coding rules. • Must have a solid foundation of insurance knowledge and guidelines for third party payers. • Must have a working knowledge of the healthcare field and medical specialty, as well as medical terminology.

🏖️ Benefícios

• PTO: Up to 96 hours in first year (pro-rated based on start date) • Holidays: 7 (New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day After Thanksgiving, Christmas Day) • Retirement: 401(k) with employer match • Health Benefits: Medical (single and family), Dental (single and family), Vision (single and family) • Other Company-Paid Benefits: Short-Term Disability, Long-Term Disability, Basic Life/AD&D, Employee Assistance Program • Other Voluntary Benefits: Voluntary Life, Accident, Critical Illness, Hospital Indemnity