Medical Billing Coordinator

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🔥 14 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $18 - $22 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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All Care To You

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

Management Service Organization (MSO)

📋 Description

• Conducts timely and accurate follow-up on professional services claims to ensure all requested information has been submitted and claims are being processed utilizing payor portals, secure chat, secure messaging, and telephone calls • Identifies missing payments from the health plan and initiates tracking procedures • Reviews incoming correspondence from health plans and takes appropriate action or escalates to designated team members as needed • Identifies pending claims and determines next steps required to obtain reimbursement for claim • Uses existing queries to review limited new denials for processing errors, appropriately assigns a status based on review, corrects any internal errors and resubmits claims as necessary • Follows up with insurance carriers, providers, or other stakeholders to gather additional information or documentation required for claims resolution • Monitors incoming messages from providers and responds to the provider or escalates the request to the appropriate team member • Identifies claims with more complex issues and escalate them to the appropriate team member for resolution as needed • Research health plan reimbursement policies and procedures, clinical guidelines, coding, and CCI edits to ensure claims are billed appropriately • Communicate effectively with insurance companies, healthcare providers, and their billing staff to resolve claims issues and answer inquiries • Document all interactions and updates in the claims management system • Maintain accurate records of claim status, actions taken, and resolutions utilizing established policies and procedures • Prepare and submit reports on claim follow-up activities and status updates to management as requested • Ensure all claims follow-up activities comply with company policies, industry regulations, and legal requirements • Stay updated on changes in insurance policies, regulations, and industry standards • Must meet quantitative production standard of working 100 – 150 claims per week • Attend departmental and company meetings as required • Identify and report trends which could have an overall negative impact on claim payments such as processing errors, denials, or billing issues • Investigate and resolve discrepancies or issues related to claims processing and payment • Work with other team members and departments ensure proper claim submission • Identify and recommend process improvements to enhance the efficiency and effectiveness of the claims follow-up process • Participate in training and development opportunities to stay current with best practices and industry trends

🎯 Requirements

• A minimum of 3 years’ experience as a medical biller or similar role • Excellent technical skills including the ability to work in multiple systems simultaneously and learn new systems quickly • EZ-Cap experience preferred • Electronic Data Interchange (EDI) Clearinghouse (Office Ally) experience preferred • Microsoft Suite – Outlook, Teams, Office365, OneNote, OneDrive, SharePoint • Sequel Server Management Studio • Confluence • Azure • Thorough knowledge of healthcare benefits, network participation, coordination of benefits, referral and authorization requirements, and insurance follow up • Working knowledge of CPT Codes, ICD-10 Codes, Modifiers, MUE, LCD, NCD, and CCI edits • Must have strong time management skills, be able to multi-task, resolve problems utilizing critical thinking, be detail oriented and highly organized • Ability to work in a fast-paced environment while maintaining strict confidentiality • Excellent written and verbal communication skills.

🏖️ Benefits

• 100% employer paid medical, vision, dental, and life coverage • Paid holiday • Paid sick time • Paid vacation time • 410k plan • Additional employee paid coverage options available