Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
JOB SUMMARY:
We are seeking a Medical Biller to perform advanced-level work related to clinical denial management and AR management. The individual is responsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned. Conducts comprehensive reviews of the claim denial, account/guarantor notes associated with the denial, and the medical record to make determinations if a revised claim needs to be submitted, if a retro authorization needs to be obtained, if a written appeal is needed, or if no action is needed. Writes and submits professionally written appeals which include compelling arguments based on clinical documentation, third-party payer medical policies, and contract language. Appeals are submitted timely and tracked through final outcome.
RESPONSIBILITIES
- Payment posting, accounts receivable follow-up, and reimbursement management
- Responsible for generating supporting documents required for insurances, Agape Pain Management and Surgery Center of Las Cruces
- Follow up on claims using various systems, i.e. practice management and clearinghouse
- Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
- Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator. Collects and compiles accurate statistical reports.
- Other responsibilities as assigned.
JOB SPECIFICATIONS
Education:
- High school diploma or equivalent
- Higher level education preferred
Experience:
- Computer knowledge
- One year’s experience working with patient accounts in the medical field
Knowledge, Skills, and Abilities:
- Strong skills in EHR
- Possess a thorough, organized and detail-oriented approach to work
- Plan, prioritize and coordinate, multi-task and complete work assignments within deadlines.
- Able to apply effective time management and self-management skills. Able to be flexible in position requiring timely response.
- Skill in organizing resources and establishing priorities
- Strong interpersonal and communication skills (written and verbal) and the ability to work effectively with a wide range of constituencies.
- Ability to foster a cooperative business environment.
- Knowledge of insurance, authorization, billing, and denial process