*Company Description*
At Avedis Medical Billing, we know the best way to predict the future of healthcare is to create it. As a member of our growing team, you will have a voice in the creation of life-changing programs and treatment centers nationwide. Working collaboratively with the best and the brightest in our industry, you will be part of an innovative team of professionals committed to generating positive and remarkable outcomes for the clients we serve. If you are looking for an organization that thrives on growth, celebrates diversity of thought, and rewards passionate execution, you’ve come to the right place. Because we put clients first, it is our honor to support and reward those who serve them.
If you are looking for an organization that thrives on growth, celebrates diversity of thought, and rewards passionate execution, you’ve come to the right place. Because we put clients first, it is our honor to support and reward those who serve them. We are a rapidly growing company that is looking for dedicated, passionate, and growth oriented individuals that will be part of the foundation of this company. In every beginning, there is the honor of serving as a pillar of strength in addition to the fulfillment of creation, prestige, and leadership within the process of starting a long journey right from the early phases.
*Essential Duties/Responsibilities*
The Billing Specialist is responsible for effective communication and coordination with Insurance companies and clients to obtain the maximum benefits for our clients. The Billing Specialist establishes relationships with insurance carriers and obtain accurate, detailed insurance benefit information by phone and via the internet. Good verbal and written communication are required. Record keeping must be accurate and thorough. Flexibility with schedule so you can meet critical deadlines as established.
In addition, the Healthcare Billing and Collections Specialist is responsible for timely and appropriate billing of healthcare claims to patients and third party payers.
*Responsibilities*
- Review census tracker and KIPU to confirm accuracy of charges to be billed.
- Create and submit claims to appropriate payors.
- Review data on insurance policies to ensure accurate claim processing and payment.
- Accurately utilize the billing system.
- Ensure corrected claims are submitted in a timely manner.
- Prepare materials for submission to insurance companies as requested.
- Contact clients to collect on outstanding account balances.
- Maintain confidentiality of patient care and business.
- Demonstrate strong, professional communication and interpersonal skills with clients, public,
- managers and co-workers.
- Perform general office duties and keep desk clean and organized.
- Maintain accurate and thorough records.
- Demonstrate the ability to act as a team player in a professional and positive manner.
- Perform other duties as assigned by supervisor
- Complete filing and follow-up of daily charge entry and submission of claims to health plans and IPAs, either electronically or by hard copy billing (secondary/crossover billing), securing medical documentation required by third party insurance as required.
- Ensure that all conditions for claim submission have been satisfied, including but not limited to: accurate charges and financial class; authorization/certification information; demographic and insurance information; ICD-10 and CPT-4 coding; patient insurance eligibility and benefit coverage.
- Submit all claims to clearinghouse on a timely basis.
- Compile and generate reports as directed.
- Understand and apply the Sliding Fee Discount Program as appropriate.
- Stay informed of changes in contracts, billing requirements and insurance types within area of responsibility; maintain knowledge of publicly funded programs, grants and third party insurance contracts including My Health LA, Medicare, Medi-Cal, managed care plans, PPOs, and HMOs. Stay current with legal and regulatory changes, and local and national trends, in coding.
- Understand and apply the Sliding Fee Discount Program as appropriate.
- Achieve and maintain days in A/R at best in class standards
- Address denials and resubmit claims as appropriate
- Work and submit all levels of appeals
- Post payments
- Follow-up with insurance carriers on unpaid claims until paid by correcting billing errors and resubmitting claims, contacting patients, contacting insurance plans, determining if a claim is a hardship case and what classification code or description should be assigned.
- Submit and follow-up on patient monthly statements; research patient inquireies.
- Evaluate accounts to determine any write-offs or corrections required, including duplicate charges
- Maintain current working knowledge of eClinicalWorks billing module.
- Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
- OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.
This is a full-time position at our corporate office.
*Qualifications*
- 1-year minimum healthcare experience with billing or insurance verification required.
- Basic understanding of insurance terminology (out-of-network benefit s vs. in-network benefits, as well as coinsurance, co-pays, and deductibles), in addition to general billing practices.
- Coding/Billing Certificate from an accredited institute or school preferred.
- Experience with behavioral health treatment preferred.
- Knowledge of SUD, IOP, and Mental Health programs.
- Knowledge and experience with EMR and billing software programs required.
- Knowledge and experience with Medics software a plus.
- Knowledge of: CPT, CDT, HCPCS and ICD-10 coding protocols, Medi-Cal, Medicare, managed care and private insurance coding and billing. Knowledge of FQHC billing protocols. Must be proficient in the use of Microsoft Office programs. Experience with professional and UB-04 claim forms.
*Ability to*:
- Communicate effectively with providers, other staff, and outside vendors. Interpret and review insurance EOBs, determine claim denial reasons and follow-up with corrections and pursue proper course of action. Must be well organized and detail oriented. Work collaboratively in a team environment, have excellent writing skills and be able to prioritize effectively. Must have a high level of accuracy, excellent analytical, problem solving and time management skills.
Job Types: Full-time, Contract, Temporary
Pay: $20.00 – $25.00 per hour
Benefits:
- Work from home
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- Weekend availability
Experience:
- ICD-10: 1 year (Preferred)
Work Location: One location