Medical Billing Specialist – AR/Collection at Sourcefit

Position Summary:

The Medical Billing Specialist – AR/Collection is responsible for researching rejections/denials, correcting/rebilling claims as necessary, and documenting all related account activities. The A/R specialist must possess critical thinking skills and be proactive when working claims to determine the appropriate method to get the claims billed out and paid. In addition, the candidate must be familiar with reading an EOB, using the insurance portals and be comfortable with calling insurance companies when necessary to obtain additional information necessary. Experience with Athena is preferred but not mandatory.

Job Details:

• Permanent work from home
• Monday to Friday - 11:00 PM to 8:00 AM OR Tuesday to Saturday - 12:00 AM to 9:00 AM Manila time
• Following US Holidays

Responsibilities:

• Monitor the status of medical claims to ensure prompt and accurate payment.
• Research and resolve claim rejections and denials, implementing measures to prevent future occurrences.
• Document all account activities accurately and in a timely manner.
• Post adjustments and manage collections from various types of payers.
• Understand and apply Medicare, Medicaid, and commercial insurance eligibility requirements and payment methodologies.
• Correctly record contractual adjustments based on payer contracts and government regulations.
• Exhibit proficiency with billing systems and leverage all functionality to ensure the most efficient processing of claims.
• Maintain up-to-date knowledge of changes in billing and coding guidelines, payer contracts, and government regulations.
• Collaborate with team members and providers, fostering a positive and productive work environment.

Qualifications:

• At least 2 years of experience in medical billing and collections is required.
• Experience in using Athena is preferred.
• Candidates must demonstrate an ability to work collaboratively with team members and healthcare providers.
• Candidates must be able to function in a fast-paced work environment and handle occasional periods of above-average pressure.
• Excellent customer service skills are necessary, as the role involves interacting with various stakeholders, including patients, insurance companies, and healthcare providers.