Advanced Pain Care · 4 months ago
Medical Billing and Appeals Specialist - Hybrid
Austin, TX, US
Full-time
Hybrid
Mid Level
3+ years expAdvanced Pain Care is a healthcare company seeking a Medical Billing and Appeals Specialist. The role involves managing insurance denials, reviewing claims, and handling correspondence to ensure correct payment amounts and resolve non-payments.
Health CareMedical
Responsibilities
Reviews and appeal unpaid and denied claims
Attaches appropriate documents to appeal letters
Researches and evaluates insurance payments and correspondence for accuracy
Logs appeals and grievances, and tracks progress of claims
Keeps up-to-date reports and notates any trends pertaining to insurance denials
Calls insurance companies to inquire about claims, refund requests and payments
Manages Accounts Receivable reports for the Billing Department
Utilizes EMR system to submit and correct claims
Posts patient and insurance payments
Sends paper claims to insurance carriers
Answers patient billing questions
Coordinates medical and billing records payments with patients and/or third-party payers
Handles collections on unpaid accounts
Identifies and resolves patient billing complaints
Answers phone calls to the Billing Department in a timely and professional manner
Processes credit card payments over the phone and in person
Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
Operates standard office equipment (e.g. copier, personal computer, fax, etc.)
Has regular and predictable attendance
Adheres to Advanced Pain Care’s Policies and procedures
Performs other duties as assigned
Qualification
Required
Requires a high school diploma or GED
Three or more years related work experience with medical billing/claims
Previous use of Athena required
Clear and precise communication
Ability to pay close attention to detail
Effectively manages day by organizing and prioritizing
Possesses excellent phone and customer service skills and abilities
Protects patient information and maintains confidentiality
Knowledge of general medical terminology, CPT, ICD-9 and ICD-10 coding
Familiarity with analyzing electronic remittance advice and electronic fund transfers
Experience interpreting zero pays and insurance denials
Competence in answering patient questions and concerns about billing statements
Organizational skills and ability to identify, analyze and solve problems
Works well independently as well as with a team
Strong written and verbal communication skills
Interpersonal/human relations skills
Company
Advanced Pain Care
Physicians & Surgeon Pain Management
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Chelsea S.
Chief Operating Officer
Christina Sons, MA , MEd
Chief Administrative Officer
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