Medical Policy Specialist jobs in Paramus, NJ

A&M Medical Services is an medical transportation company searching for an experienced medical billing specialist. Looking for someone who will communicate with insurance companies, government programs and other pay sources; coordinates with collections agency on unpaid claims; under general supervision, evaluates and interprets medical treatment records, medical diagnostic coding and billing information; performs related work as assigned.

Essential Duties & Responsibilities

• Obtaining referrals and pre-authorizations as required for procedures.
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
• Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle time frame.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating billing software with rate changes.
• Updating cash spreadsheets, and running collection reports.

Proficiency in the following areas is preferred:

• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Competent use of computer systems, software, and 10 key calculators.
• Familiarity with CPT and ICD-10 Coding.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• A calm manner and patience working with either patients or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to multitask.

Preferred:

Previous ambulance billing experience and demonstrated knowledge of third-party billing procedures and claim review and analysis strongly preferred.

Job Type: Full-time

Monday-Friday

1st shift 8:00am to 4:30pm

Hourly rate: based on experience

Required experience:

·Medical Office: 2 years minimum

· Word, Outlook, Excel: 3 year

· Ability to shift priorities: 3 year

· Excellent written and verbal skills: 3 year

Job Type: Full-time

Pay: Competitive

Job Type: Full-time

Pay: $19.00 - $23.00 per hour

Expected hours: 40 per week

Benefits:

• Employee discount

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Office

Experience:

• ICD-10: 2 years (Required)

Ability to Relocate:

• Paramus, NJ: Relocate before starting work (Required)

Work Location: In person