Medical Billing A/R Specialist - FQHC experience required

Medic Management Group, is an Ohio based health care services entity specializing in providing services including: medical billing, collection recovery, credentialing, coding & auditing, consulting, and practice management., Medic Management Group has a wide variety of clients covering private practices, post-acute care facilities, hospitals and health systems, and clinical research institutions.

If you are looking for a company that delivers outstanding client service, while encouraging its employees to grow and provides a welcoming team environment, then we have a wonderful opportunity for you!

We are currently looking to hire Medical Billing A/R Specialist with FQHC experience to join our team!

Our goal as a Medical Billing A/R Specialist is to ensure physician services are billed in a timely manner and to obtain the highest reimbursement. To achieve this goal we focus on using our available technology to process unpaid claims and payments as efficiently as possible. We manage the follow up on denied claims, claims edits, and rejections so they may be resubmitted in a timely manner.

Responsibilities:

• Read and understand explanations of benefits to perform medical billing functions.
• Knowledge of CPT, Modifiers, and ICD-10 codes
• Assure all charges are entered within 24-48 hours of receipt from the physicians/providers.
• Make necessary changes to patient accounts (address, name, telephone number, and insurance changes, etc.)
• Assure all claims are sent electronically on a daily basis
• Review and work claim edits and rejections on a daily basis.
• Paper claims are sent on a weekly basis.
• Patient statements are sent on a monthly basis or weekly based on volume.
• Post all insurance and patient payments within 24-48 hours of receipt (batched by date of receipt and daily balancing is required).
• Work all denials at the time of receipt.
• Prepare and send appeals.
• Begin insurance follow-up at 31 days for claims.
• Answer telephone calls regarding all medical billing inquiries.
• Submit copies of overpaid accounts to Billing Manager for review.
• Work patient AR based on the practice policy.
• Send accounts to collection based on practice policy.
• Maintain strictest confidentiality of patient private health information (PHI) by disclosing only information requested.
• Handle all electronic processes relating to claims submission, remit posting etc.
• All practice records received should be scanned to client folders on the company network drives.
• Performs additional duties as requested by upper management.

Qualifications:

• High school graduate or equivalent.
• Requires minimum of 5 year experience in medical billing with at least 3 years experience in FQHC's.
• Proficiency with A/R follow up required.
• Knowledge of medical billing systems.
• Knowledge of and experience with working unpaid claims for all insurance payers, Medicare, Medicaid, Bureau of Workers’ Comp.
• Advanced knowledge of behavioral health insurance policies and carriers.
• Familiar with local coverage determinations.
• Understanding of how in and out-of-network benefits work and how customary rates work.
• Previous experience in a customer service environment
• Ability to meet deadlines, production goals, and work under pressure
• Ability to read, understand and follow oral and written instructions; able to follow multiple practice policies.
• Ability to professionally communicate with patients and co-workers on all medical billing inquiries.
• Ability to communicate clearly and concisely using correct grammar, correct spelling and punctuation usage required in notes and emails.
• Ability to multi task.
• Ability to operate a telephone system.
• Knowledge of using Microsoft Products (MS Outlook, MS Teams, Word, Excel software programs)
• General knowledge of utilizing office equipment: computer, copier, fax, scanner.

Physical Demands

• Work may require sitting for long periods of time
• Occasionally lifting files or paper up to 20 lbs
• Operating a computer, keyboard, a calculator, telephone, copier, fax, scanner or other such office equipment during a normal business day
• Will require viewing computer screens and typing on computer keyboards for prolonged periods of time

This job description is intended to provide a basic guideline for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as necessary.

As a Medic Management employee you are offered our competitive compensation package, which includes exceptional health benefits, ancillary benefits, and 401(k) plan with a company match. Each employee is provided a generous amount of paid time off and seven paid holidays which are immediately available.

Medic Management is an Equal Opportunity Employer.'