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Koya Medical, Inc. · 1 month ago

Billing Specialist - Accounts Receivable & Denials

Dallas, TX

Full-time

Onsite

Entry, Mid Level

$55K/yr - $60K/yr

2+ years exp

Koya Medical, Inc. is a transformative healthcare company developing breakthrough treatments for venous diseases and lymphedema. They are seeking an experienced Billing Claims Specialist to manage claims submission and follow-ups with various insurance payers, ensuring accurate and timely processing and payment.

BiotechnologyHealth CareInternetPharmaceutical

Responsibilities

Ensure timely and accurate billing of claims via electronic or paper to Medicare, Medicaid, and Commercial Insurances in accordance with policy using primarily Niko Health claim submission software and Salesforce

Work with all payers to ensure medical claims are being processed timely and paid accurately

Analyze and post EOB payments and denials in all billing systems, ensuring correct processing and payment. Determine root cause and prevention of future rejections & denials, advising management and appeals team where necessary

Route claims and/or balances that are deemed uncollectible to Financial Patient Responsibility Review or Write Off Queues timely and appropriately

Assist and communicate effectively with our patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible

Able to Identify process improvement opportunities and recommend potential solutions to improve departmental workflow

Assist with any other duties or projects on an as needed basis

Maintain regular and punctual attendance

Comply with all company policies and procedures, HIPAA and all state and federal regulations

Must meet or exceed production & quality KPI standards

Qualification

Medical billing experienceClaims processingMedicare knowledgeMedicaid knowledgeCommercial Insurance knowledgeNiko Health softwareSalesforce proficiencyMicrosoft Office proficiencyAttention to detailCommunication skillsProblem-solving skillsOrganizational skillsTeam collaboration

Required

Able to operate at a task and project level

High School diploma or equivalent

A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as it pertains to DME billing

Ability to take direction and communicate effectively with customers and employees at all levels of the organization

Ability to thrive in a fast-paced and dynamically changing organization

Must have a strong work ethic

Excellent oral and written communication skills

Strong attention to detail

Ability to prioritize and manage daily responsibilities effectively

Solutions-oriented problem solver

Excellent planning, communication and organizational skills

Preferred

Some College and/or medical billing certificate

2 years of Medicare, Medicaid and/or Commercial Insurance experience, particularly in HME

Intermediate knowledge/proficiency in Microsoft Office products and Salesforce

Benefits

Base + bonus compensation package

Competitive benefits program

Company

Koya Medical, Inc.

Koya Medical is a transformative healthcare company developing breakthrough treatments for venous and lymphatic diseases to increase movement, mobility and personalized care that is unavailable with traditional compression therapy.

Founded in 2018

Oakland, California, USA

51-200 employees