Statement of Purpose: This position is accountable for all steps in the billing process including processing medical claim information through data-entry in the EMR, and researching and correcting data entry errors using eClinicalWorks. This position uses knowledge of CPT and ICD-10 codes to accurately depict medical claim information. This position is in a primary care and behavioral health social service setting with specialized LGBTQ+ care and services.
- Review claims data to ensure that assigned codes meet required legal and insurance rules, and that required signatures and authorizations are in place prior to submission
- Submitting claims for services rendered to insurance companies
- Verifying patients’ insurance coverage
- Working directly with the insurance company, the patient, and clinic staff to get claims appropriately processed and paid timely
- Reviewing and appealing denied and unpaid claims
- Monitoring and updating patient AR balances
- Tracking and updating the Aging Report, and working patient accounts for accuracy.
- Answering questions patients may have about billing
- Reviewing patient bills for accuracy and completeness and obtain any missing information
- Handling collections and unpaid accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when there is a lapse in payment.
- Minimum of 2 years of experience as a medical billing specialist in primary care and behavioral health setting highly preferred.
- Experience working with multiple third party payers including Medicaid, Medicare, Managed Care, HMO/PPOs.
Knowledge, Skills and Competencies Required:
- Strong knowledge of and able to easily navigate Medicaid, Medicare, HMOs, and private payer systems
- Knowledge of EMR systems, preferably with eClinicalWorks.
- Microsoft suite and data systems proficiency, including Electronic Medical Records.
- Ability to effectively communicate both written and verbally.
- Ability to effectively utilize problem-solving and decision-making techniques.
- Ability to make effective judgments and decisions based on objective criteria.
- Attentive to detail and strong organizational skills.
- Ability to tactfully interact with diverse personalities.
- High comfort working in a busy environment with changing priorities.
- Must possess and maintain valid Florida driver’s license and proof of insurance
- Must have reliable and accessible auto vehicle.
- Must pass necessary fingerprinting, Level II background checks and employment eligibility verification through the U. S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp.
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