Reimbursement Specialist - Healthcare jobs in Springfield, MA

Billing Specialist
Westfield, MA

Job Summary:

BayMark Health Services is looking for a detail oriented and conscientious candidate for our Billing Specialist role. The Billing Specialist will assist the billing supervisor with billing activities, responsible for monitoring denials, appeals, and resolutions from participating insurance carriers and working proactively to collect from insurance carriers.

Essential Duties & Responsibilities:

• Tracks all incoming claims denials (Mail, EOB’s, from clinics).
• Review denied claims, makes required corrections and resubmits to appropriate insurance within 10 days of receipt of denial.
• Verify if claim denial is a COB (Coordination of Benefits) claim and sends to appropriate insurance with COB information required.
• Enter claims and COB information into website for patients with Mass Health as secondary insurance.
• For claims that are not COB, charges patients for patient responsible amounts from EOB’s.
• Enter new patient insurance information into billing software if changes are found.
• Enters alerts into system to alert fiscal clerks to patient charges added to account.
• Check insurances online or calls insurance to verify eligibility as needed.
• Run Alpha List update spreadsheet and other reports as needed
• Enters authorizations as they are received.
• Maintains confidentiality of all information; adheres to all HIPAA guidelines and regulations.
• Ability to handle stressful situations and interact with others.
• Must be present during working hours at the office for in person meetings and access to a computer without violating company policy.
• Other related duties and responsibilities as determined by Supervisor.

Qualifications:

• High school diploma or equivalent required.
• Minimum of 3 years of experience in an office setting preferred.
• Experience with Medicare, Medicaid, Commercial Insurances, etc. required.
• Experience with Insurance Eligibility verification required.
• Must be computer literate (programs, software, email, spreadsheets).
• Proficient with Microsoft Word & Excel required.
• Excellent verbal and written communication skills required.
• Typing and data entry skills required.
• Working knowledge of Health and Safety requirements preferred.
• Satisfactory drug screen and criminal background.

Benefits:

• Competitive salary
• Comprehensive benefits package including medical, dental, vision and 401(K)
• Generous paid time off accrual
• Excellent growth and development opportunities
• Satisfying and rewarding work striving to overcome the opioid epidemic

Here is what you can expect from us:

BayMark Health Services a progressive substance abuse treatment organization is committed to the highest quality of patient care in a comfortable outpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.

BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran’s status or any other classification protected by State/Federal laws.