Medical Billing Specialist - Community Wellness Technology

WORK FROM HOME IN THE DANVILLE, KY AREA!!! (CONTRACT TO HIRE)

We are looking for a motivated, organized, and talented A/R Medical Billing Specialist to join our team, focusing on managing the billing process specific to the healthcare industry. This role involves handling medical claims, patient invoicing, and coordinating with insurance companies to ensure accurate and timely payments.  Become part of a team where your power to improve lives is exponential.

Job Purpose: Responsible to manage the accounts receivable process within a healthcare setting. This role involves processing medical claims, handling patient billing, managing collections, and ensuring accurate and timely reimbursement from insurance companies and patients. The specialist will work closely with healthcare providers, patients, and insurance representatives to resolve billing issues and maintain financial accuracy.

Responsibilities:

• Prepares, submits, and follows up on medical claims to insurance companies and government agencies.
• Performs insurance verification to identify appropriate payer(s).
• Ensures claims are accurate, complete, and compliant with billing regulations and payer requirements.
• Reviews and correct any errors or omissions in claims before submission.
• Monitors and manages outstanding accounts receivable balances, including patient invoices and insurance claims.
• Reconciles patient accounts, applies payments, and handles adjustments and refunds as needed.
• Follows up on unpaid or denied claims, and initiates appeals or resubmissions when necessary.
• Generates and sends patient invoices, ensuring clarity and accuracy of charges.
• Addresses patient billing inquiries, resolves discrepancies, and provides detailed explanations of charges and payment options
• Implements collection strategies for overdue accounts, including payment plans and coordination with collection agencies if required.
• Communicates with insurance companies and healthcare payers to resolve billing issues and obtain payment information.
• Negotiates and verifies payment rates, and ensure compliance with payer contracts and policies.
• Addresses and resolves issues related to claim denials, underpayments, and overpayments.
• Maintains accurate records of billing transactions, payments, and account adjustments.
• Generates and reviews reports on accounts receivable status, aging reports, and collections.
• Assists in the preparation of financial reports and summaries for management review.
• Adheres to healthcare regulations, including HIPAA privacy rules, and maintains confidentiality of patient information.
• Ensures billing practices comply with federal, state, and payer-specific guidelines.
• Identifies opportunities for improving billing processes and increasing efficiency.
• Collaborates with other departments to streamline workflows and enhance revenue cycle management.
• Performs other duties as assigned.

 Here are our MUST HAVES:

Required Education, Experience, Certifications / Licensure, & Skills:

• High school diploma or equivalent; Associate's degree in Medical Billing and Coding, Healthcare Administration, or a related field preferred and THREE TO FIVE years of experience or the equivalent comination of education and experience.
• Strong knowledge of medical coding (ICD-10, CPT, HCPCS) and billing procedures.
• Proficiency in billing software and electronic health record (EHR) systems.
• Familiarity with Medicare billing is a must.
• Possesses a thorough understanding of denial codes.
• Experienced in the insurance appeals process.
• Excellent analytical and problem-solving skills with high attention to detail.
• Strong organizational skills and ability to manage multiple tasks efficiently.
• Effective communication and interpersonal skills, with the ability to handle sensitive information professionally.

Preferred Experience and Skills:

• Experience with Advance MD
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)

Requirements:

Job Type (FLSA Status): Contract to Hire
Pay: 16.83 to 19.23 
Ability to commute/relocate: This is a work from home position that eventually may require reporting in-person to the Danville, KY facility.
Work Location: Work From Home