INSURANCE BILLING SPECIALIST-REMOTE

This is a Full Time REMOTE Position

Compensation

Range: $25.04 to $37.56 Benefits: Medical, Dental, Life, Retirement, Paid Time Off Position Classification: Non-exempt ESSENTIAL FUNCTIONS AND BASIC DUTIES: Supervisory-Specific Performance Expectations, Duties, and Responsibilities:

• N/A

Position-Specific Performance Expectations, Duties, and Responsibilities:

• Process and submit health insurance claims to various insurance companies in a timely and accurate manner.
• Ensure claims are coded correctly in compliance with the latest medical coding and billing guidelines (CPT, ICD-10, HCPCS). Collaborate with the coding and clinical departments to resolve edits and denials.
• Maintain a working knowledge of Medicare and Medicaid as well as commercial payer guidelines, and stay abreast of new policy changes.
• Verify patient eligibility and coverage details before claim submission, and reconcile coverage denials when necessary.
• Resolve claim edits both in the electronic medical record and in the clearinghouse to prevent denials.
• Follow up with insurance companies regarding denied or underpaid claims, and submit appeals when appropriate.
• Review insurance and patient credit balances and resolve them timely.
• Educate patients on their billing inquiries, providing clear and accurate explanations regarding their insurance coverage and payment responsibilities.
• Document all actions taken with an account in the electronic medical record (EMR).
• Performs other duties as assigned.

Organization-Specific Performance Expectations, Duties, and Responsibilities:

• Demonstrates 100% commitment to performance in accordance with the CHOICE values of MRH and representing the organization in a positive and professional manner.
• Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff, and vendors.
• Adheres to MRH attire/dress code per policies and procedures.
• Utilizes initiative; strives to maintain a steady level of productivity; self-motivated; and manages activity and time.
• Completes annual education, training, in-service, and licensure/certification requirements; and attends departmental and organizational staff meetings or reads meeting minutes.
• Maintains patient confidentiality at all times.
• Reports to work on time as scheduled; completes work within designated timeframes.
• Actively participates in departmental and organizational performance improvement and continuous quality improvement activities.
• Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state, and federal regulations and policies.
• Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, the public, and staff.

QUALIFICATIONS: Minimum Requirements:

• Must be at least 16 years of age (21 for driving positions with a valid driver’s license).
• Must be able to legally work in the United States.
• Must be able to pass a background check.
• Must be able to pass a drug screen and breath alcohol test (if applicable).
• Must complete employee health meeting.

Required Education/Licensure/Certification:

• Medical billing or coding certification highly desired (CPC, CPB, RHIT, CCS, etc.).
• High School Diploma or equivalent, preferred.

Experience:

• Two (2) years prior experience in medical billing, accounts receivable, or related field required (can substitute with a medical billing or coding certification (CPC, CPB, RHIT, CCS, etc.).
• Knowledge of UB-04 and CMS-1500 claim forms, preferred.
• Epic or similar EMR experience, preferred.
• Prior authorization process experience, preferred.
• Typing speed of a minimum of 30 WPM, preferred.
• Proficiency in Excel, preferred.

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