Accounts Receivable, Accounts Receivable Management, Billing, Code Coverage, Communication Skills, Current Procedural Terminology (CPT), HIPAA (Health Insurance Portability and Accountability Act), Healthcare, ICD-10, Insurance, Insurance Claims, Interpersonal Skills, Maintain Compliance, Medical Billing, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft Word, Patient Confidentiality, Performance Metrics, Problem Solving Skills, Regulatory Compliance, Reimbursement, Talent Management, Time Management
Insurance Billing Specialist
Manage daily billing functions for assigned patient insurance companies. Coordinate the interaction between patients and payors to facilitate timely reimbursement. Serve as a point of contact for billing problem solving. In depth knowledge of carrier ClinicalCoverage Policies (CCP) and Billing Coverage Policies (BCP).
Specific responsibilities include:
- 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
- May post and balance activity from carrier remits to include payments, contractual adjustments, and other adjustments
- May post and balance 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
Key competencies include:
- Communication Skills
- Decision Making
- HealthCare Knowledge
- Interpersonal Skills
- Organizational Values
- Problem Solving
Specified skills:
- Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required.
- Spanish speaking skills preferred.
Physical demands: Not Applicable.
Education and experience:
- High School Diploma or GED equivalent required
- One (1) year of relevant billing experience preferred
Schedule:
Regular attendance on-site at our Westridge Enka/Candler location is an essential function of this position. Typical business hours are Monday – Friday, 8:00 am to 5:00 pm (or flexed to best meet the needs of the clients and/or the Division); 40 hours per workweek; weekend, holiday, or evening coverage is occasionally required. Work hours will need to be flexible in order to respond to special work assignments, or evening activities, as requested by the team leader.
Position compensation: $23.65/hour, full time + full benefits
MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer.
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Mountain Area Health Education Center