Medical Billing Specialist

🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 10%

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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 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 submitting claims • Answer patient account inquiries and assist with alternative payment plans when necessary • Maintain patient account records and settle third-party payer issues • Review Daily Reconciliation Review documents for accuracy and enter charges into the Practice Management System • Prepare and review patient statements before release through the Practice Management System • Ensure timely filing of Medicare, Medicaid, and third-party insurance claims • Balance daily charges and reconcile them with Practice Management System reports • Collaborate with the revenue cycle manager and payers on denials and rejections • Work with practice representatives to ensure proper insurance verifications and authorizations are obtained • Perform other duties as assigned

🎯 Requirements

• GED or better, or High School or better • Comply with applicable legal requirements, standards, policies, and procedures, including Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act • Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer • Professional communication with patients and guarantors regarding balances or account information • Participate in required orientation and training programs • Cooperate with monitoring, audit functions, and investigations • Participate in process improvement responsibilities • Meet productivity goals • Successful completion of required training • Handle multiple priorities effectively • Problem-solving skills to manage a variety of concrete variables • Effective verbal and written communication skills • Ability to interpret instructions presented in a variety of situations • Strong organizational skills and ability to manage multiple projects simultaneously • Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer • Ten-key speed and accuracy

🏖️ Benefits

• Reasonable accommodations for qualified individuals with disabilities • Benefits (mentioned in equal employment opportunity policy; specific offerings not listed)