Medical Biller - HealthyU Family Medicine

Billing Specialist

The Biling Specialist is responsible for processing claims for all clients, identifying and resolving claims issues adversely impacting the revenue cycle management process and achieving resolution through coordination, reconciliation, and denied claim management. In addition, follow internal and external policies and procedures to ensure accurate revenue is booked by monitoring payments, fee schedule changes, health plan reimbursement changes and any other aspects that impact revenue, cash collections and adjustments.

Essential Job Functions:

• Properly codes services, procedures, diagnoses, and treatments
• Prepares and sends invoices or claims for payment or reimbursement
• Corrects rejected claims and ensures accuracy
• Track payments
• Follows up with patients and insurance companies about outstanding invoices
• Ensures accuracy
• Medical coding and generating claims in Athena
• Following up on completed claims, EOBs and verifying posting of claims
• Follow up on denials and correcting claims if down-coded
• Addressing claims placed in various hold categories by Athena staff

Qualifications:

Minimum Qualifications:

• High school diploma or equivalent
• Has a minimum of 3 years of Athena medical billing Experience with CPT and ICD-9/10; Familiarity with medical terminology Knowledge of billing procedures and collection techniques in Primary Care
• Adhering to company standards of compliance with policies and procedures
• Strong written and verbal communication skills Detail-oriented with the ability to work independently and prioritize workload Efficient and accurate charge entry and coding
• Effective organization and multitasking skills are essential Microsoft Office experience Strong Microsoft Excel experience
• Possess a thorough understanding of billing codes, AHCCCS, and have worked closely with insurance claims representatives in resolving claim issues
• Knowledgeable in AHCCCS, Medicaid, CMS guidelines and coding policies, RCM compliance and goals.
• Understanding of current coding and billing regulations and compliance requirements.
• Computer skills- EMR and MS Office (Excel, Word, Outlook) to write and update notes and generate reports
• Strong analytical and problem-solving skills
• Excellent Interpersonal
• Strong attention to detail

Preferred Qualifications:

• Coding certificate
• Bachelor's degree

Physical Requirements

• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at a time.

Work Environment:

• Typical office environment.
• This role routinely uses standard office equipment such as computers, phones, and photocopiers.