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Variety Care · 4 months ago

Billing, Claims Resolution Specialist (66966)

Oklahoma City, OK, USA

Full-time

Onsite

Entry Level

2+ years exp

Variety Care is dedicated to providing quality healthcare services, and they are seeking a Bilingual Claims Resolution Specialist to join their Billing department. This role focuses on resolving unpaid claims by working directly with patients and third-party payers to maximize revenue and improve the overall health of Accounts Receivable.

Health CareMedicalNon Profit

Responsibilities

Works collaboratively with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine the focus of collection efforts after running the weekly AR report

Contacts third-party payers about outstanding balances and provide requested documentation to achieve resolution

Contacts patients with outstanding balances to obtain payment or set up payment plan

Sends patient statements and collection letters on past due balances

Tracks and follow-up monthly on payment plans to ensure compliance

Performs write-offs, adjustments, and refunds as directed

Works closely with the Billing team to initiate and respond to billing inquiries, requests for additional information, and outstanding balance resolution

Answers patient calls and billing questions

Processes medical records requests for payers from attorneys

Assists front desk staff with patient inquiries

Assists front desk staff with obtaining correct patient addresses

Meets established daily, weekly, monthly, and annual deadlines

Manages and maintains relationships with all payors to improve patient revenue

Upholds Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information

Follows written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist

Exhibits professionalism in communication with patients, clients, insurance companies and co-workers

Participates in special projects as assigned

Supports Variety Care’s accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provides leadership and work with all staff to achieve the goals of the 'Triple Aim' of healthcare reform—to improve the experience of care, improve health outcomes, and decrease healthcare costs

Embodies the strength of personal character. Places value on being an open and honest communicator who displays high moral and ethical conduct, integrity, adaptability, and sound judgment. Must be a leader in the department and community. Result-oriented problem solver who is responsible and accountable

Performs other duties as assigned

Qualification

BillingCollections experienceCPT codes knowledgeExplanation of Benefits (EOB) understandingMicrosoft Office proficiencyBilingual (English/Spanish)Critical thinkingProblem-solving skillsCommunication skillsDependabilityThoroughnessDecisivenessFlexibilityInitiative

Required

High School Diploma or GED

Two years prior billing and collections experience

Working knowledge of CPT codes

Ability to read and understand Explanation of Benefits (EOB) issued by insurance carriers

Expert critical independent thinking, analytics, problem-solving and sound decision-making skills

Experience interacting and communicating effectively with individuals at various levels both inside and outside the organization, often in sensitive situations

Proficient with Microsoft Office and practice management software systems

Bilingual (English/Spanish)

Preferred

Associate degree or equivalent combination of experience and education

Prior medical billing and insurance collections or healthcare revenue cycle experience including diversified experience with payers, managed care contracts, and payer methodology