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Company

CarepathRx · 1 day ago

Billing Specialist

United States

Full-time

Remote

Entry Level

1+ years exp

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DeliveryHealth Care

No H1B

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Responsibilities

Understand Third Party Billing

Identify root cause of issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials.

Ensure the timeliness and accuracy of billing

Meet quality assurance, benchmark standards and maintain productivity levels as defined by management.

Processes patient and insurance changes

Processes Home Infusion/Nursing claims

Processes rejections for NCPDP emails to determine if the claim needs to be refiled or submitted for an appeal with the payer

Able to identify billing trends

Performs other duties as assigned

Qualification

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Medical billing experienceInsurance policiesMedical billing practicesHome InfusionICD9CPT4HCPCS knowledgeThird party payorsMicrosoft Office proficiencyCustomer service backgroundEffective problem-solving skillsTime-management skillsTeamwork skills

Required

Must have experience processing medical claims.

Ability to communicate with patients, payors, outside agencies, and public through telephone, electronic and written correspondence.

Effectively communicate in English; both oral and written, with physicians, location employees and patients to ensure questions and concerns are processed in a timely manner.

Helpful, knowledgeable, and polite while maintaining a positive attitude.

Interpret a variety of instructions in a variety of communication mediums.

Knowledge of Home Infusion.

Knowledge of insurance policies and requirements.

Knowledge of medical billing practices and of billing reimbursement.

Maintain confidentiality and practice discretion and caution when handling sensitive information.

Multi-task along with attention to detail.

Must be able to accurately perform simple mathematical calculations using addition, subtraction, multiplication, and division.

Self-motivation, organized, time-management and deductive problem-solving skills.

Work independently and as part of a team.

High school graduate or equivalent.

Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.

High school diploma or GED equivalent.

One to three years of related prior work experience in a team-oriented environment.

Experience in medical field and administrative record management.

Strong customer service background.

Employment is contingent on background investigation (company-wide).

Employment is contingent on drug screen (when applicable for the position).

Valid driver's license in state of residence with a clean driving record (when applicable for the position).

Preferred

Collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred.

Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.

Knowledge of HCN 360 and/or CPR+ preferable.

Medicare knowledge of billing requirements specific to DMEMAC.