Mountain Area Health Education Center - MAHEC · 5 hours ago
Revenue Cycle Billing Specialist
Mountain Area Health Education Center (MAHEC) is seeking a Revenue Cycle Billing Specialist to manage daily billing functions for patient insurance companies. The role involves coordinating interactions between patients and payors, resolving billing issues, and ensuring compliance with billing policies.
Health CareHospitalMedical
Responsibilities
Maintain Accounts Receivable KPI (A/R balances older than 120 days must be less than 19% of total A/R)
Maintain Adjusted Collection Percentage KPI (Reimbursement/Collections equal to or above 97% of Expected)
Review and resolve denied patient insurance claims
Assist in identifying current and/or potential billing issues specific to unpaid claims
Post and balance all activity from carrier remits to include payments, contractual adjustments, and other adjustments
Post and balance all payments from patients
Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked
Correct errors on electronic error reports
Process and print/transmit patient insurance claims, bills and other reports
Respond to patient account inquiries in person, by phone, or by mail; resolve problems as necessary
Respond to inquiries from office staff regarding patient charges, appropriate diagnosis coding, and insurance coverage related issues
Respond to inquiries from employees, payers, and patients regarding CPT and ICD-10 codes
Maintain high level of patient confidentiality
Ensure compliance with HIPAA regulations
Other duties as assigned
Qualification
Required
In depth knowledge of carrier Clinical Coverage Policies (CCP) and Billing Coverage Policies (BCP)
Maintain Accounts Receivable KPI (A/R balances older than 120 days must be less than 19% of total A/R)
Maintain Adjusted Collection Percentage KPI (Reimbursement/Collections equal to or above 97% of Expected)
Review and resolve denied patient insurance claims
Assist in identifying current and/or potential billing issues specific to unpaid claims
Post and balance all activity from carrier remits to include payments, contractual adjustments, and other adjustments
Post and balance all payments from patients
Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked
Correct errors on electronic error reports
Process and print/transmit patient insurance claims, bills and other reports
Respond to patient account inquiries in person, by phone, or by mail; resolve problems as necessary
Respond to inquiries from office staff regarding patient charges, appropriate diagnosis coding, and insurance coverage related issues
Respond to inquiries from employees, payers, and patients regarding CPT and ICD-10 codes
Maintain high level of patient confidentiality
Ensure compliance with HIPAA regulations
Regular attendance on-site is an essential function of this position
Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required
Preferred
Spanish speaking skills preferred
Benefits
Full benefits available
Company
Mountain Area Health Education Center - MAHEC
The Mountain Area Health Education Center (MAHEC) is a leader in healthcare practice, education, innovation and research.