Statement of PurposeThis 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.

 

Primary Tasks/Responsibilities:

  • 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 patientsโ€™ 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.

 

Education/Professional:

  • 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.

Requirements:

  • Must possess and maintain valid Florida driverโ€™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 Securityโ€™s E-Verify system, https://e-verify.uscis.gov/emp.

 

To apply for this job email your details to careers@metrotampabay.org