Medical Billing Specialist

🔥 12 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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American Health Partners

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1976

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

American Health Partners is a healthcare organization focused on improving access to and coordination of high-quality care through a continuum of services tailored to institutional and special-needs populations. The company operates institutional special needs health plans and provides specialized care coordination, geriatric inpatient and acute psychiatric care, and pharmacy services for long-term-care facilities, supported by an owned/affiliated network of locations and thousands of contracted providers. American Health Partners emphasizes convenient, preventive care to reduce costly hospital stays and improve patient outcomes and quality of life.

📋 Description

• Process and mail/transmit medical claims • Track claims • Monitor authorization and eligibility of payor benefits • Manage the collections process and post cash receipts • Extract and verify billing information from medical records • Ensure collection of past-due balances and follow up as needed • Verify patient demographic and insurance information before claim submission • Answer patient account inquiries and assist with alternative payment plans • Maintain patient account records and resolve third-party payer issues • Review Daily Reconciliation Review documents and enter charges into the Practice Management System • Prepare and review patient statements before release through the Practice Management System • File Medicare, Medicaid, and third-party insurance claims timely • Balance daily charges and reconcile PMS reports • Collaborate with the revenue cycle manager and payers on denials and rejections • Work with practice representatives to ensure insurance verifications and authorizations are obtained • Report suspected non-compliance to the Chief Compliance Officer • Perform other duties as assigned

🎯 Requirements

• GED or better, or High School or better • Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer • Ten key speed and accuracy • Problem solving skills to manage a variety of concrete variables • Effective verbal and written communication skills • Ability to interpret instruction presented in variety of situations • Strong organizational skills; ability to manage multiple projects simultaneously • Ability to comply with HIPAA, Corporate Compliance Program, Corporate Code of Conduct, Federal False Claims Act, and applicable legal requirements • Ability to communicate professionally with patients and guarantors • Ability to participate in required orientation and training programs, monitoring and audits, investigations, and process improvement • Ability to meet productivity goals and successfully complete required training • Ability to handle multiple priorities effectively

🏖️ Benefits

• Reasonable accommodations for qualified individuals with disabilities • Training programs • Benefits • Equal employment opportunity regarding compensation, training, benefits, transfers, and other employment conditions