Medical Billing Specialist

Company: Spark Talent
Location: Wyoming
Posted on: March 14, 2020

Job Description:

Medical Billing Specialist

About the Company:

Spark Talent Acquisition is a Michigan-headquartered recruiting and staffing company that connects great talent with great employers. We understand that finding a new position can be stressful and identifying top talent can be challenging. For us to maximize successful placement and retention, we start by listening to and understanding each of our clients. We believe in face to face interaction and having a solid understanding of our client's business before placement. We pride ourselves in team development as it matches our purpose as an organization to continually create career opportunities.

Summary:

The Medical Billing Specialist will review, research, and process claims in accordance with contracts and policies to determine the extent of liability and entitlement, as well as to adjudicate claims as appropriate. The core responsibilities will include coding and processing claim forms; reviewing claims for complete information, correcting and completing forms as needed; accessing information and translating data into information acceptable to the claims processing system; and preparing claims for return to provider/subscriber if additional information in needed. This is a full-time, direct hire opportunity!

Primary Responsibilities:

--- Submit 3 rd party and patient claims (electronically and manually), including the maintenance of bill holds and the corrections of errors in an effort to provide timely, accurate billing services.
--- Perform all billing and follow-up functions, including the investigation of over-payments, underpayments, payment delays resulting from denied, rejected and/or pending claims.
--- Research claim rejections, make corrections, take corrective actions and/or refer claims to appropriate staff members for follow through to ensure timely claim resolutions.
--- Proactively follow-up on delayed payments by contacting patients and 3rd party payers, and supplying additional data, as required;
--- May perform financial counseling activities, including but not limited to:

- Seeks appropriate funding based upon patient requirements, collecting supporting documentation (payroll stubs, tax returns, credit history, etc.), as required. Provides information and education to the patient, family member and/or guarantor of the application/documentation process. In so doing, the incumbent will encourage patient participation in the funding process and will assist the patient in forwarding the required documentation and application to the appropriate funding agency:
- Counsels patient/guarantor on patient's financial liability, third party payer requirements and outside financial resources, including private organizations and foundations, eligibility vendor(s), Medicaid, Medicare, Champus, and/or federal disability programs, etc.;
- Counsels patient/guarantor of payment plan options and establishes appropriate plan;
- Investigates No Fault and Workers' Compensation cases, retrieving police report and insurance information, as required;
- Assists patient/guarantor in completing a charity application, financial statement and/or payment contract when required according to hospital policies. Analyzes such applications along with income/resident documentation in order to advise the patient of available options. Initiates requests for charity write-off, when appropriate;
- Analyzes financial and eligibility data, and length of disability to determine potential eligibility for federal, state, and/or county programs, completing the necessary documents within the time limits specified by the appropriate government agency;
- Determines and manages proper course of action for optimal reimbursement of healthcare charges (e.g., spend down eligibility, out-of-network, Cobra coverage, etc.); and

Minimum Qualifications:

--- High school diploma or an equivalent combination of education and experience. Associate degree in accounting or business administration high desired. Data entry skills (50-60 keystrokes per minutes).
--- Past work experience of at least 1 year within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing medical claims processing, financial counseling, financial clearance and/or customer service activities is required.
--- Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required.
--- Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-10, CPT, HCPCS), and basic computer skills are highly desirable.
--- Excellent communication (verbal and writing) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers. Accuracy, attentiveness to detail and time management skills are required.

What the Company Offers:

--- Competitive wages
--- Assorted benefits packages that includes medical, dental and vision coverage
--- Free yoga classes and healthy living seminars

Keywords: Spark Talent, Wyoming , Medical Billing Specialist, Accounting, Auditing , Wyoming, Michigan