Seeking an A/R specialist with medical billing experience to support a dedicated team of health care providers in their Bay Area practice.
This healthcare organization has several clinics and hospitals in Northern and Southern California. Currently, they are growing at a rapid pace and are looking for qualified Medical Billers immediately.
The ideal candidate will have a strong background in A/R and medical billing, with the skills necessary to improve their current billing procedures. The successful applicant will work on a number of tasks,exercising their billing experience within the practice.
To provide thorough follow-up and/or re-billing of unresolved ASC insurance claims. Specific responsibilities include:
· Responsible for performing claim research and follow-up work with insurance companies to resolve accounts which have been billed but remain unresolved.
o Reviewing notes on client systems to see what work has already been performed.
o Determining next steps by either calling the insurance company or using electronic tools to determine claim status.
o If no claim is on file, it will need to be re-billed through the client's systems.
o If a claim is rejected, find out why and make a determination if it can be re-billed with proper information, if it should be patient responsibility, or if it is a timely filing issue.
o If coding needs to be changed, submit to appropriate group for review.
· Work specific payers and accounts as assigned by management.
· Responsible for submitting accounts to be written off or changed to patient responsibility.
· Responsible for claim denials and determining how to resolve the claim either by correction, re-billing, or if it was rejected authorization issues.
· Providing weekly reports on claims worked, re-billed, and submitted for write-off.