Medical Billing Specialist - Collections
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AI Summary
The specialist is responsible for managing the revenue cycle by calling carriers to inquire about payment status and auditing billing discrepancies. They must follow up on denied claims, handle appeals, and ensure compliance with HIPAA regulations.
Position Summary:
Our client is seeking a tenacious and detail-oriented Medical Billing Specialist - Collections. The ideal candidate will have experience in mental health and/or substance abuse treatment billing, or revenue cycle management. This role is integral to ensuring accurate billing processes and effective revenue cycle management, contributing to the financial health of our organization.
Job Details:
- Work from Home
- Monday to Friday | 9 PM to 6 AM (Manila Time)
Responsibilities:
- Call carriers and inquire about payment status on claims according to our in-network contracts.
- Audit discrepancies between billing and payment delays/denials.
- Verify insurance payment accuracy and compliance with contract and customary charges.
- Follow up on unpaid or denied claims and appeal & send medical records as necessary.
- Demonstrate knowledge of third-party payers’ Explanation of Benefits (EOBs) and understand specific time limitations for appeals for all served lines of business.
- Maintain confidentiality of patient information and adhere to HIPAA regulations.
Qualifications:
- Experience with CollaborateMD billing software (preferred, not required).
- Strong attention to detail and accuracy in coding and billing processes.
- Excellent communication skills to interact with healthcare providers, insurance companies, and patients.
- Ability to work independently and prioritize tasks effectively.
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