Medical Billing Specialist Regenesis Biomedical
THIS JOB HAS EXPIRED Description
The Medical Billing Specialist ensures that all appropriate insurance referrals, authorizations and claims are processed within established timeframes and that all insurance data is correctly entered into the ERP system. The position requires collection of necessary medical records, interaction with physician?s offices and sales manager support. Must be articulate with the ability to be proactive when communicating with insurance companies, case managers and Utilization Review Boards. The Medical Billing Specialist must have working knowledge of Worker?s Compensation Insurance processes.
ESSENTIAL DUTIES & RESPONSIBILITIES
Maintain ongoing tracking and appropriate documentation of referrals, authorizations and claims to ensure maximum approval and collection rates.
Prepares and submits clean claims to various insurance companies either electronically or by paper.
Reviews accounts for possible assignment and makes recommendations to the Claims and Patient Care Manager
Ensure complete and accurate patient / payer data, including patient demographic and current insurance information, necessary medical history, diagnosis, prognosis, etc.
Contact case managers and insurance companies to ensure prior approval requirements are met within the specified time frames.
Provide specific medical information to insurance companies to maximize claim reimbursement.
May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
Ensure that referrals and authorizations are addressed in a timely manner.
Be a liaison between departments to ensure effective collections / reimbursement processes are maintained.
Assure appropriate telephone / email / fax coordination with patients, sales managers, billing agencies, physician offices, etc.
Assure timely shipping of product to patients.
Submit claims to the insurance company and reconciles payments.
Interacts with and supports Sales Managers.
Other tasks as assigned
CORE COMPETENCIES / KNOWLEDGE & SKILL REQUIREMENTS
Time management skills and multi-tasking abilities required.
Proactive, articulate, and forward-thinking attitude.
Good organizational skills.
Extremely accurate in data entry.
Intermediate to advanced skills in Excel, Word and Outlook.
Detail-oriented; flexible and creative.
Interpersonal and communications skills to work effectively with all levels of staff.
EDUCATION, EXPERIENCE & TRAINING REQUIRED
Associates Degree or Medical Billing Degree preferred.
3 or more years of previous related medical billing background consisting of referrals, authorization, billing and collections.
Familiar with Workers Compensation policies and procedures.
Previous experience with treatment denials and appeals.
Medical terminology, CPT and ICD-9 coding.
Clear understanding of how to submit paper and electronic claim forms.
Bilingual a plus
||1435 North Hayden Road |
Scottsdale, AZ 85257
THIS JOB HAS EXPIRED