Pharmacy practice looking for experienced Medical Billing / Collections Specialists.

Must have knowledge of Medicare, Medicaid, and Commercial HMO/PPO billing and appeals guidelines. Need to be proficient with ICD-10 and coding guidelines.

Responsibilities:

• Experience and knowledge of Medicare, Medicaid, and Commercial HMO and PPO billing guidelines.
• In-depth knowledge of CPT coding guidelines and ICD-10.
• Experience with Medicare and Medicaid billing guidelines, insurance reimbursement methods, claims appeal process, understanding of managed care contracts and capitation payments, and experience with billing and collections of physician commercial insurances.
• Ability to process rejections and denials to determine if a claim needs to be refilled, submitted, or appealed to the payor/carrier.
• Prepare and run reports on a regular basis to identify and target unprocessed claims and/or denials in a timely manner.
• Identify coding or billing errors from EOBs and work to correct them.
• Monitor insurance claims/denials and contact insurance companies to resolve denials for proper payment.
• Oversee patient accounts – ensure timely payments and/or establish repayment plans and arrangements with delinquent patients.
• Review patient information to determine or identify claims denial causes.
• Responsible for maintaining accounts receivable and creating a reduction in bad debt.
• Additional duties as assigned by Management team.

The right candidate should possess the following skills and qualifications.

• Medical terminology
• HIPAA / Legal compliance and documentation skills
• Accounts receivable and payable skills
• Experience with medical billing software, reporting and EMR systems.
• Computer Skills - Word and Excel a must.
• Claims appeals / EOB knowledge
• Knowledge of Medicare/Medicaid guidelines as well as Private payors in the industry.
• Organization and attention to detail.
• Excellent phone/communication skills
• Exceptional negotiation skills
• Ability to work in a high-pressure environment
• High school diploma/GED
• College degree is preferred
• Prior medical billing and collection experience is required

Additional:

• Pay: $16.00
• Benefits: Health, dental, vision insurance. as well as paid time off packages

*

Job Type: Full-time

Pay: From $15.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: One location

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