Enrollment & Billing Director oversees one or more departments responsible for enrollment and billing operations for an insurance company. Ensures information accuracy and customer satisfaction. Being an Enrollment & Billing Director establishes and implements organizational policies. May offer guidance on appropriate handling of complex or high-value accounts. Additionally, Enrollment & Billing Director typically requires a bachelor's degree. Typically reports to top management. The Enrollment & Billing Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be an Enrollment & Billing Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
PGM Billing, LLC is seeking applicant(s) interested in full time work. Employee (s) will be responsible for supporting billing team by working insurance company medical denials. Day-to-day tasks include downloading manual denials and posting denial reasons into billing system, working denials by taking appropriate action to turn denial into payment, and communicate denial requests, details or trends to account representative.
Fulltime workers will be expected to work in the physicals office. After probationary period has passed, worker may have the option to work a combination of in-office and remote.
Duties -
- Support dedicated Account Representative in A/R follow-up and denial management.
- Follow up on unpaid claims by calling insurance carrier to challenge denials and resolve any billing discrepancies
- Noting accounts in billing system with an action taken to resolve denials
- Access insurance carrier portals or third party intermediary portals to track down denial reasons and/or payment details
- Make necessary updates to the practice management software or clearinghouse website to re-submit claims previously denied for payment
- Assign or identify appropriate CPT codes (ICD-9, DRG, ICD-10), diagnoses codes, and modifiers.
- Verify patient insurance coverage
- Maintain confidentiality of patient information and adhere to HIPAA regulations
- Stay updated on changes in medical coding systems and billing procedures
Experience:
- Minimum of 2 years of experience in medical billing or coding
- Proficiency in medical coding systems (ICD-9, DRG, ICD-10)
- Knowledge of medical office procedures and medical collection practices
- Strong attention to detail and accuracy in coding and billing processes
- Works well with others in a team setting
- Ability to work independently and meet deadlines in a fast-paced environment
Job Type: Full-time
Pay: $15.00 - $20.00 per hour
Expected hours: 35 – 40 per week
Benefits:
Schedule:
Work setting:
Work Location: Hybrid remote in Lyndhurst, NJ 07071
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