Medical Biller I (CPS)
East Haven, CT Billing
Job Type
Full-time
Description

CPA medical Billing a division of GeBBS Health Care company is currently seeking an experienced medical biller to join their team. Connecticut based candidates only.

The Medical Biller/Accounts Receivable Specialist is one of the most important components to revenue cycle management as this role play an integral part in getting the doctors paid. This position requires a vast array of different skills that when applied properly deliver a positive result in a timely manner.

Responsibilities and Duties:

Research:

  • Work aged accounts on assigned payers prioritizing accounts that are approaching timely filing denial.
  • Devote time weekly to work current rejections 1 to 90 days old. Fix errors and re-bill accordingly.
  • Look up payer eligibility using payer websites or call payers to gather needed information for billing. Update all accounts in the system for that patient and promptly re-bill.
  • Contact guarantors as needed to determine insurance coverage. Drop tickets having no insurance to self-pay and bill patient.
  • Work and identify the reason for the credit balance. Be sure everything going to the patient is self-pay. Review tickets on hold, checking chart to be sure they should be on hold and release after days on hold for that payer if dollars exist.

Appeals:

  • Initiate appeals to payers following the guidelines outlined for that payer. Note account and track appeal to resolution.

Accountability:

  • Enter notes on all tickets with action taken and paste any proof of insurance eligibility.
  • Be prepared to account for action taken on tickets. Participate in meetings as instructed by management.
  • Provide work status updates to management upon request that may including running statistical reports.
  • Meet or exceed all set deadlines and goals.
  • Promptly inform management of any problems or changes with system or payers identified during the course of daily work.

Assistance:

  • Offer assistance and share knowledge with co-workers either when asked or when necessary for the betterment of completing tasks, the overall account and company.

Personal Development:

  • Participate in personal development training and cross training as instructed by management.
  • Understand and follow all payer rules when setting up billing schemes on accounts to ensure accurate claims.
  • Follow protocol by informing managerial staff of any problems and never contact clients without the prior management approval.
  • Understand coding rules and schemes to detect potential claim errors. Consult with coders on those accounts in question.

Office Policies:

  • Adhere to all office policies at all times.
  • Maintain confidentiality at all times.
  • Work special projects as assigned.
  • Retrieve voice mail several times daily and return all calls within 24-hour period.
  • Participate in being “part of the team” – contribute to a calm but enjoyable workplace environment.
Requirements

Qualifications and Skills:

  • At least 1-3 years of full-time medical billing accounts receivable work
  • Availability to work full-time (40 hours per week) between the hours of 8am and 6:00pm Monday through Friday (no weekends)
  • Strong work ethic and ability to work independently in a very busy office
  • Prior experience using Athena is preferred
  • Private practice knowledgeable
  • Completion of Medical billing/ coding program or certification is strongly preferred