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Huntsville Memorial Hospital logo
Huntsville Memorial HospitalHuntsville, TX
Under general supervision of the Supervisor of Billing, the Billing and Collections Representative completes daily billing and AR follow up for assigned scope, in accordance with established criteria. Includes the daily reconciliation of assigned reports and controls to ensure claims are billed accurately and timely. Coordinates follow up with providers, clinic, and hospital staff as needed. Serves as the first point of contact for customer calls and inquiries regarding billing and claim payment. Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position. Resolves daily billed claim edits and rejections: target Clean Claim rate of 95% or greater: Resolution of Electronic Billing System (EBS) client, payer, and/or clearinghouse acceptance and rejection reports Monitor and follow up to identify and resolve discharged not final billed holds (DNFB) Process Balance Bill claims to next payer after primary/secondary claims are accurately adjudicated Accurate completion of UB04 and/or 1500 claim form/field requirements, by payer (condition, occurrence and value codes, etc.) for primary, secondary, and tertiary claims Accurately interpret payer specific Explanation of Benefits (EOB) and Remittance Advice (RA) to identify claim modification and/or special billing requirements Monitor and release claims to meet Timely Filing requirements Review/Resolve hold claims and release to billing w/in 24 hours Submit clean claims for outpatient & inpatient hospital services and Rural Health Clinics Combine claims as appropriate to ensure compliance with applicable billing rules and regulations, including but not limited to: CMS Payment Window Rule Series Claims/Recurring Services Packaged/Bundled Services Worker’s Compensation Department of Transportation (DOT) Accident and Other Liability Attorney and/or Probate Balance Billing (secondary/tertiary payers) Resolves denied claims: target denial rate of Authorization, Pre-Certification, and Referrals Other Billing Issues Medical Record Copies Credentialing Issues Coding Charge Capture Medical Necessity and/or ABN Issues Identify and resolve recurring provider/clinic-specific claim delays: registration demographic profile, eligibility and Iplan assignment, authorization/pre-certification/referrals, medical necessity and/or ABN, charge entry and coding accuracy. Performance Improvement Opportunities: Compiles information and contributes to the trending of Bill Holds and Denials for performance improvement by Provider, by Payer & by Reason/ Reason Code. Achieves daily targeted individual productivity and performance outcomes for: daily productivity, Clean Claim submission rate, & quality assurance. Provides backup as needed to the Scheduling and Registration staff in the Rural Health Clinic by answering phones, scheduling, and performing patient registration. Abides by the HMH Legal Compliance Code of Conduct. Maintains a safe work environment and reports safety concerns appropriately. Maintains confidentiality and appropriate handling of PHI. Performs all other related duties as required and assigned Requirements Education: High school diploma or GED required. Graduate of a formal billing/coding program required. Experience: Five years of business office experience in a healthcare setting required. Required Skills: Excellent interpersonal, customer service, problem solving, and written and oral communication skills. Working knowledge of CPT codes and ICD-10 codes. Benefits Health Care Plan (Medical, Dental & Vision) Retirement Plan (401k, IRA) Life Insurance (Basic, Voluntary & AD&D) Paid Time Off Short Term & Long Term Disability Training & Development Wellness Resources

Posted 30+ days ago

ClinDCast logo
ClinDCastTampa, Florida
We are seeking highly experienced HRP Consultants with a strong background in Premium Billing to join our team. The ideal candidates will possess extensive expertise in HealthRules Premium Billing and demonstrate the ability to create and draft Business Requirements Documents (BRD) . Key Requirements: Proven experience with HealthRules Premium Billing . Strong ability to develop and document Business Requirements Documents (BRD) . Hands-on experience with HealthRules is mandatory. Prior exposure to Enrollment processes is preferred but not required. Mandatory Skills: ✔ HRP (HealthRules Payor) ✔ Premium Billing ✔ Enrollment Empowering the Future of Healthcare The healthcare Industry is on the brink of a paradigm shift where patients are increasingly being viewed as empowered consumers, utilizing digital technologies to better understand and manage their own health. As a result, there is a growing demand for a range of patient-centric services, including personalized care that is tailored to each individual's unique needs, health equity that ensures access to care for all, price transparency to make healthcare more affordable, streamlined prior authorizations for medications, the availability of therapeutic alternatives, health literacy to promote informed decision-making, reduced costs, and many other initiatives designed to improve the patient experience. ClinDCast is at the forefront of shaping the future of healthcare by partnering with globally recognized healthcare organizations and offering them innovative solutions and expert guidance. Our suite of services is designed to cater to a broad range of needs of healthcare organizations, including healthcare IT innovation, electronic health record (EHR) implementation & optimizations, data conversion, regulatory and quality reporting, enterprise data analytics, FHIR interoperability strategy, payer-to-payer data exchange, and application programming interface (API) strategy.

Posted 30+ days ago

DEX Imaging logo
DEX ImagingTampa, Florida
Description DEX Imaging is a leading provider of document handling equipment and services with multiple offices and locations throughout the United States. We are the nation’s largest independent provider of office technology. We are the industry leader in delivering excellent customer service every time and we do this by hiring and training great people. Working as a Billing Administrator you can expect: Full time schedule, working 40 hours a week Full benefits and competitive pay Opportunity for training, development, and promotion Excellent corporate discounts Employee recognition and rewards program Competitive PTO and Paid Holidays If your career goals include being an integral part of a team in a dynamic, innovative and upbeat atmosphere, then you belong right here on our award winning team. What’s the opportunity: We are looking for a Billing Administrator to ensure the day-to-day billing for their assigned branches are completed accurately and in a timely manner. Your job will be to support and assist other departments with any billing disputes and questions . What will you do: Assist and supports team with the development and implementation of departmental goals, policies, procedures, budgets and reporting tools and change. Support internal and external customers. Work closely with AR and Accounting department to ensure timely resolution to minimize collection issues. Produce monthly billing metrics, revenue analysis & reporting Reconcile monthly collections to open accounts; investigate any discrepancies; work with Branch Manager and Controller in order to resolve receivable balances. Collect information from customers for daily processing of data for billing. Review, coordinate, and address invalid invoice submissions to ensure accurate and timely collection of revenue. Report progress, operational issues, organizational opportunities and threats to the regional team on a monthly basis or as needed. Provide administrative and clerical tasks that aid the daily service billing operations. What you bring to the table: High school diploma required and at least 1 year of related experience. Microsoft Office Suite Customer service experience via email and phone. Basic math skills. Attention to detail, data entry accuracy, and excellent organizational skills. Ability to multitask. Able to work independently and as a productive team member. Experience with E-Automate a plus! What can DEX provide to you: Opportunity and career development In house training Company culture where we celebrate our team members A place where you can build a career, not just have a job The preceding job description has been designed to indicate the general nature of work performed; the level of knowledge and skills typically required; and usual working conditions of this job. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be requires by employees in the job. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations made to enable individual with disabilities to perform essential functions. This job description does not imply or cannot be considered as a part of an employment contract. DEX Imaging as an Equal Opportunity Employer.

Posted 1 week ago

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Excelsia Injury CarePleasant Grove, Utah
About Us Excelsia Injury Care provides management services to a network of healthcare companies, supporting them in delivering comprehensive rehabilitation, diagnostic, surgical, and pain management services for individuals affected by post-traumatic neuro-musculoskeletal injuries. With 95 locations across Idaho, Illinois, Maryland, Missouri, Nevada, New Jersey, Pennsylvania, Utah, and Virginia, we ensure accessible, high-quality care tailored to each patient’s unique needs. Our providers are leaders in personal injury and workers’ compensation care, with a proven track record of helping patients recover and reach their maximum recovery potential. Our mission is to restore quality of life through patient-centric care, supporting those injured in motor vehicle or work-related accidents. We take an interdisciplinary approach, ensuring patients receive coordinated care from evaluation through treatment, with the goal of achieving optimal recovery outcomes. Founded on the values of respect and trustworthiness, we are committed to delivering services that adhere to the highest legal, regulatory, and ethical standards. As responsible corporate citizens, we integrate environmental, social, and governance (ESG) considerations into our business practices, ensuring that we positively impact the healthcare companies we serve, our employees, and the communities we reach. Job Duties (duties may vary based on region and location) Requesting any missing dictations from provider Renaming and printing Dr. Leiberman’s EMGs/Procedures Matching bills with all supporting docs once charges are entered and bills printed (per day and provider) Mailing/faxing of bills, and scanning completed faxed bills Assistance with Rehab Billing Assist with printing Rehab bills and exporting/printing corresponding notes Assistance with mailing/faxing of all Rehab bills, and scanning completed faxed bills A/R-Collections Assistance Assist with billing out “Insurance Pending” accounts Assist with following-up on medical cases Back-up support for UR records requests (WC) Back-up payment posting support (ie personal health insurance EFTs, medical records payments, month end help as needed) Reviewing denials for exhausted MVA’s and any other pertinent correspondence to be brought to collectors’ attention for review/follow-up Minimum Requirements High school diploma or GED equivalent Additional Skills/Competencies Ability to maintain a strong confidentiality profile Ability to form interpersonal relationships (i.e. establish rapport with others) Ability to manage time effectively by setting priorities Physical/Mental Requirements Sitting, standing, walking, reaching above shoulder length, working with body bent over at waist, working in kneeling position, climbing stairs, climbing ladders, working with arms extended at shoulder length, lifting max. of 20 lbs. Diversity Statement Excelsia Injury Care is an equal opportunity employer. We commit to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religion, creed, gender, pregnancy or related medical conditions, age, national origin or ancestry, physical or mental disability, genetic predisposition, marital, civil union or partnership status, sexual orientation, gender identity, or any other consideration protected by federal, state or local laws.

Posted 1 week ago

Sea Mar Community Health Centers logo
Sea Mar Community Health CentersFederal Way, Washington

$21+ / hour

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without regard to race, ethnicity, immigration status, gender, or sexual orientation, and regardless of ability to pay for services. Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services. We are recruiting for the following position: Sea Mar is a mandatory COVID-19 and flu vaccine organization see job description Hourly - Hourly Plan, 20.76 USD Hourly What We Offer: Sea Mar offers talented and motivated people the opportunity to work in a dynamic and growing community health organization. Working at Sea Mar Community Health Centers is more than just a job, it’s a fulfilling career with opportunity for advancement. The fringe benefits surpass most companies. For example, Full-time employees working 30 hours or more, receive an excellent benefit package of: Medical Dental Vision Prescription coverage Life Insurance Long Term Disability EAP (Employee Assistance Program) Paid-time-off starting at 27 days per year + 10 paid Holidays. We also offer 401(k)/Retirement options and an exciting opportunity to work in a culturally diverse environment. Please visit our website to learn more about us at www.seamar.org. You may also apply thru our Career page at https://www.seamar.org/jobs-general.html

Posted 30+ days ago

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MedVanta CareersHagerstown, Maryland
MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO). Our services are specifically designed for musculoskeletal (MSK) providers and go beyond that of a traditional MSO, empowering our clients with the precise infrastructure, data, technology, and administrative processes needed to thrive both today and tomorrow. MedVanta has an employee centered culture that supports and promotes diversity and inclusion. Our encouraging and empowering management style makes MedVanta a great place to further grow your knowledge while building a team driven path to success. The Central Billing Office (CBO) Accounts Receivable Representative is responsible for performing a variety of complex accounts receivable-related functions for the Central Billing office. The CBO Accounts Receivable Representative reports directly to the designated Central Billing Office leader. Duties include, but are not limited to: Investigates and resolves denied claims. Works and manages claims from all aging buckets, including posting, appeals, ADRs. Identifies and reviews delinquent accounts and pursues collection as needed. Performs and documents follow-through efforts in a timely manner. Coordinates medical record documentation to be submitted with appeals. Communicates accurate patient and billing information to insurance carriers. Prepares weekly status reports for review with management. Assists with medical biller duties, including but not limited to handling insurance claims, submitting claims to insurance, collecting, posting, and managing patient account payments, and preparing and reviewing patient statements. Other duties as assigned. Required Education & Experience High School Diploma. 2+ years of related experience, with experience in an orthopaedic setting preferred. Proficiency with Microsoft Office suite of products well as electronic billing systems. Extensive knowledge of insurance, benefits, medical terminology, and medical billing. Experience working with billing and accounts receivable or both commercial and non-commercial payors. Competencies/Required Skills & Abilities Strong interpersonal skills - ability to develop relationships and collaborate and influence in a centralized organization. Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results. Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience. Able to work independently. Exudes professionalism in presentation. Physical Demands Must be able to sit for long periods of time and lift up to 25 pounds Must be able to use appropriate body mechanics techniques when performing front desk duties. Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting. Adequate hearing to perform duties in person and over telephone. Must be able to communicate clearly to patients in person and over the telephone. Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.

Posted 30+ days ago

Acrisure logo
AcrisureSpringfield, Illinois

$15 - $17 / hour

Job Description General Description The Billing Specialist assists the Senior Accountants in monitoring the insured accounts receivable, servicing the billing issues of our insureds and agents and processing the daily accounting transactions such as vendor payables and insured payments. ESSENTIAL FUNCTIONS Answer phone calls from the accounting phone queue. Calls are typically insureds and agents making payments, requesting information or asking questions regarding their bills and/or coverage. The specialist must be knowledgeable about billing procedures and worker’s compensation insurance overall. Monitors insured receivables. This includes communicating with insureds regarding late payments and turning accounts over to our collection agencies as necessary. The specialist are also in charge of ensuring refunds are sent out timely according to company policy. Posts insured payments to their accounts and creates deposits to go to the bank Processes Vendor Payables Print Checks (claims, insured refunds, commissions) Special projects assigned by Senior Accountant Competencies/qualifications Strong telephone and/or customer services skills Strong verbal/written communication skills Proficient computer skills including but not limited to Microsoft Office suite; specifically Excel. Good organizational and multi-tasking abilities. Quick critical thinking skills Education/Experience requirements Minimum Education: High School Diploma or equivalent Preferred Education: Some college course work in accounting. 1+ years of general business/office experience 1+ years of customer service preferable over the telephone Work environment This job operates in a clerical, office setting. This role routinely uses standard office equipment such as computers, telephones, photocopiers and the like. Working over the telephone with challenging persons should be expected. Physical requirements Sitting for 4+ hours of time is usual in this role Candidate should be able to lift 10-15 pounds. Large amounts of keyboarding and working with a computer mouse requires dexterity of the hands. Bending over to file periodically is also required The candidate must be able to use close, distance, and color vision. Benefits and Perks: Competitive compensation Generous vacation policy , paid holidays, and paid sick time Medical Insurance, Dental Insurance, and Vision Insurance (employee-paid) Company-paid Short-Term and Long-Term Disability Insurance Company-paid G roup L ife insurance Company-paid Employee Assistance Program (EAP) and Calm App subscription Employee-paid Pet Insurance and optional supplemental insurance coverage Vested 401(k) with company match and financial wellness programs Flexible Spending Account ( FSA ) , Health Savings Account (H SA ) and commuter benefits options Paid maternity leave, paid paternity leave , and fertility benefits Career growth and learning opportunities …and so much more! Please note: This list is not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Offerings may vary based on subsidiary entity or geographic location. Pay Details: The base compensation range for this position is $15 - $17. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity. Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant . To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.

Posted 1 day ago

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Light & WonderLas Vegas, Nevada
Corporate: Light & Wonder’s corporate team is comprised of incredible talent that works across the enterprise, defying boundaries to provide essential services in an extraordinary manner to ensure the success of the organization and the well-being of employees. Position Summary Focused on helping achieve the Finance Shared Services mission of serving the business accurately, efficiently, and politely with the vision to operate silently in the background so the business can maximize profitability. This is accomplished by preparing manual-based customer invoices accurately and timely. Essential Job Functions: Record, store, and analyze information Calculate, prepare, and issue invoices and credits Research customer issues and resolve in a timely manner Verify the accuracy of data Provide invoices at request Provide audit data upon request Communicate with internal and external customers to process accurate bills and resolve conflicts Responsible for monitoring and maintaining assigned accounts Must communicate with sales, management and collections regarding customer accounts and potential delinquencies Must know general accounting principles to be able to provide revenue coding for manual invoices Perform other activities as assigned Adhere to department policies, procedures, and expectations Qualifications Education: High school diploma Experience: Minimum 2 years in billing, finance or accounting Knowledge, Skills, & Abilities: Proficiency in Microsoft Office applications and an aptitude to learn new computer programs Demonstrated communication skills (including active listening, writing, and emotional intelligence) Detail oriented with demonstrated administrative and organizational skills and ability to prioritize and manage multiple assignments simultaneously Ability to work independently with minimal direction Ability to maintain confidentiality, use discretion, and make sound judgment Good organizational skills Attention to detail Data entry experience Basic Accounting principles Ability to analyze data and be able to perform a reconciliation Work Conditions: Generally work in an office environment. Light & Wonder and its affiliates (collectively, “LNW”) are engaged in highly regulated gaming and lottery businesses. As a result, certain LNW employees may, among other things, be required to obtain a gaming or other license(s), undergo background investigations or security checks, or meet certain standards dictated by law, regulation or contracts. In order to ensure LNW complies with its regulatory and contractual commitments, as a condition to hiring and continuing to employ its employees, LNW requires all of its employees to meet those requirements that are necessary to fulfill their individual roles. As a prerequisite to employment with LNW (to the extent permitted by law), you shall be asked to consent to LNW conducting a due diligence/background investigation on you. This job description should not be interpreted as all-inclusive; it is intended to identify major responsibilities and requirements of the job. The employee in this position may be requested to perform other job-related tasks and responsibilities than those stated above. LNW is an Equal Opportunity Employer and does not discriminate against applicants due to race, ethnicity, gender, sexual orientation, veteran status, or on the basis of disability or any other federal, state or local protected class. #LI-JM1 Light & Wonder is an Equal Opportunity Employer and does not discriminate against applicants due to race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. If you’d like more information about your equal employment opportunity rights as an applicant under the law, please click here for EEOC Poster .

Posted 1 day ago

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American InstituteCherry Hill, New Jersey

$26 - $28 / hour

American Institute, founded in 1924 as the Hartford Secretarial School, provides hands-on training for careers in the world of business, legal, allied healthcare, diagnostic medical sonography, and information technology. Recognizing our single, well-defined teaching mission: reflecting job market demands with flexibility in identifying and incorporating new programs to give our graduates an edge in today’s competitive job market. Medical (including prescription), Dental, Vision (Company subsidized) FSA/HSA (Depending on Medical Plan chosen) $50,000 Life Insurance (Company paid) Additional Voluntary Life Insurance (Team Member paid) Employee Assistance Program – EAP (Company paid) Long Term Disability (Company paid) Short Term Disability (Team Member paid) Supplemental Insurance such as Critical Illness, Accident, and Hospital (Team Member Paid) Paid Time Off – 15 days accrued in year 1, 9 holidays, and 1 day of Volunteering Time Off 401k (eligible upon completion of 90 days of employment and must be at least 21 years of age) Pet Insurance Identity Theft Protection Purpose of the Position: As an Instructor, you will empower students by delivering engaging and effective instruction. You collaborate closely with program leaders and other departments to enhance student success, foster retention, support certification, celebrate graduation milestones, and facilitate successful career placements. Our commitment lies in promoting the overall well-being and integrity of our educational programs and our students. What you’ll do: Deliver Centralized Curriculum : Teach the standardized education curriculum according to an assigned schedule. Create a learning environment that fosters students’ academic growth and guides their professional development. Engage Students : Facilitate discussion forums and interactive course contributions to promote student interaction and engagement. Avail self to students other than class time, e.g., office hours, for additional educational engagement. Monitor Student Progress : Grade course activities and post grades on a weekly basis. Proactively track student performance and provide timely academic feedback. Support Student Success : Create learning support tools tailored to students’ demonstrated needs. Provide academic feedback in a constructive, positive, and timely manner. Maintain Professionalism : Adhere to policies, maintain an up-to-date faculty file, and communicate effectively with program leadership and students per established expectations and timelines. Perform other duties as assigned . Career Level Expectations: Applies broad theoretical job knowledge typically obtained through post-secondary education or equivalent work experience. Work is supervised. Handles problems and uses critical thinking to solve. Communicates facts, policies and practices related to job area. Desire for growth and professional development. Required Skills/Experience: High school diploma/GED 3 years of verifiable experience in medical coding and billing Skills and abilities – communication and presentation skills, organization, people-orientation, time management, and high energy. Ability to professionally communicate fluently in verbal and written English. Ability to support a diverse and inclusive work environment. Computer literacy/basic computer skills to effectively navigate and utilize the technology required for the role. Preferred Requirements: Prior teaching experience Certified Professional Coder (CPC) certificate Experience applying adult learning principles and practices to blended learning. Proficient in MS Office (Word, Excel, PowerPoint) and other business tools such as Microsoft Teams. Other skills and abilities - ability to inspire students to meet career goals by tying course curriculum to potential career outcomes; familiarity with learning management systems, student information systems, and synchronous instructional tools. Compliance: Demonstrate knowledge of and carefully follow all applicable federal and state compliance requirements and regulations including those prescribed by the U.S. Department of Education, accrediting agencies, state regulations, and internal policies and procedures. Effectively communicate compliance requirements to other staff as appropriate and quickly escalate any compliance concerns to the Compliance department. Work Environment/Physical Demands: This is a campus position; in-person instruction, office hours, laboratory work, and preparation time are required. Home office set up, quiet place to work, and ability to hard wire into high-speed internet connection. May require setup of computer equipment; accommodation consideration available upon request. Flexibility to work evenings and weekends, as needed. Anticipated starting salary is based on experience and qualifications. Compensation Range $26 - $28 USD OUR CORE VALUES Caring We believe every student has the potential to be successful in a rewarding career, with the right support. We partner with you from your first day of classes through your search for a job after graduation. Respect We view everyone who enters American Institute as a productive adult who deserves respect and the opportunity to excel. Our staff and instructors are dedicated to helping you achieve your goals and realize your potential. Service American Institute is committed to the professional and academic success of each student by actively seeking opportunities to provide service both within the campus as well as within the surrounding community. Integrity We look forward, not backward. No matter where you come from or what obstacles you’ve faced in the past, we believe your future is yours to create. Accountability When you commit to us, we commit to you. When you walk into American Institute, we focus on helping you continue to move forward, so you can create the life you want to live. Innovation We know that the sooner you have the knowledge and skills you need to begin your career, the sooner you can become successful. American Institute offers focused, practical training that gets you out of the classroom and on your way faster than you thought possible.

Posted 1 week ago

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Wolcott, Wood and TaylorChicago, Illinois
*MUST LIVE IN ILLINOIS OR A STATE SURROUNDING ILLINOIS TO APPLY* The Ambulatory Coding and Reimbursement Specialist is responsible for reviewing, analyzing, and coding ambulatory and/or hospital encounters, diagnostic and procedural information used in the billing of charges for physician’s services. Ensures compliance with established coding procedures, regulatory guidelines and reimbursement policies. Reviews medical record documentation for E/M encounters from multiple specialty departments for proper assignment of ICD-10, CPT, HCPCS and modifiers. Performs initial charge review to determine appropriate CPT and ICD-10 codes to be used in reporting physician services to third party payers. Essential Duties and Responsibilities: Analyzes provider documentation to assure the appropriate Evaluation & Management levels are assigned using the correct CPT and current Evaluation and Management Guidelines Interprets outpatient office visit notes and charge documents to determine services provided and accurately assign CPT , Modifiers, and ICD-10 coding to these services. Performs a comprehensive review of the record to assure all vital information such as patient identification, signatures, and dates are present in the record. Evaluates the records for documentation consistency and adequacy. Ensured that he inlay diagnosis accurately reflects the care and treatment rendered. Monitors and follows up to ensure all services billed are captured and coded. Follows and adheres to all WWT policies such as Coding Audit Policy and Physician Coding Query In-Basket Policy Provide real time feedback to providers on all coding changes and trends via EPIC in basket message Actively participates and engages coding team meetings regularly and if needed Reviews all physician documentation to ensure compliance with third party and regulatory guidelines. Works in coordination with other members of the physician’s office/departments as necessary. Collaborates with Coding Management for special coding and billing projects if assigned. Apply coding knowledge and skills to resolve coding denials from payers and works with management and various departments. Resolving coding denials assigned by applying coding knowledge and skills. Maintains active coding credentials and CEU’s required for coding roles. Performs other related duties as required and assigned. Knowledge, Skills & Abilities Knowledge and understanding of medical coding and billing systems and regulatory requirements Communication - communicates clearly and concisely, verbally and in writing. Persistence – comfortable pursuing, rebutting and escalating issues as appropriate. Goal-oriented – holds him/herself accountable to achieving shared professional and personal goals. Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations. Interpersonal skills – establishing and maintaining effective working relationships with employees, and external parties. PC skills - demonstrates high proficiency in Microsoft Office applications, especially Microsoft Excel, and others as required. Writing skills –advanced writing skills with ability to present a compelling argument, punctuate properly, spell correctly and transcribe accurately. Education/Experience : Certified professional coder CCS-P, CPC, RHIT or RHIA through AAPC or AHIMA with a minimum of two years’ experience with CPT/ICD-10 coding of multispecialty services preferred. Responsible for maintaining continuing education per certification requirements. Clear understanding of protocols and procedures in a medical office including health information management, confidentiality, and safety. Organize and prioritize responsibilities while remaining flexible to changing demands. Excellent written and oral communication skills, with the ability to interact with patients, families, staff and others. Strong analytical skills and attention to detail Ability to establish priorities and work independently Must have high level of discretion and judgment.

Posted 4 days ago

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Aeroflow CareerAsheville, North Carolina
Aeroflow Health – Billing Representative- Urology- Fully Remote Opportunity Aeroflow Health is taking the home health products and equipment industry by storm. We have created a better way of doing business that prioritizes our customers, our community, and our coworkers. Aeroflow believes in career building. That is why we promote from within and reward individuals who have invested their time and talent in us. Whether you are looking for a place from which to launch your career - or a stable, ethical company in which to advance you will not find an organization better equipped to help you meet your professional goals than Aeroflow Health. The Opportunity Within Aeroflow, there are 4 main divisions: Urology, Diabetes, Mom & Baby, & Sleep. Each division specializes in a specific set of medical supplies aimed to treat a medical diagnosis or the symptoms of that diagnosis. Aeroflow Urology focuses on incontinence products such as diapers, underpads, and catheter supplies Supplies are shipped directly to more than 100,000+ patients a month across the nation who have medical insurance and a urinary incontinence diagnosis Aeroflow Urology is a leader in the incontinence industry. With a focus on outstanding customer service, Urology has maintained a 4.9 out of 5 star average on over 7000+ Google reviews The Urology Billing team specifically addresses denied claims that are sent to insurance for payment, provides medical documentation to insurance carriers, addresses insurance audits, and so much more Your Primary Responsibilities We are currently seeking a Urology Billing Representative. The duties and responsibilities for this role include: Performing analytical work of denied claims Research insurance payer requirements Solving problems and finding innovative solutions Ability to prioritize multiple responsibilities Making and receiving calls with a professional demeanor Understanding reimbursement policies Comfort with technology Monitor reports to identify trends, concerns, and/or areas of improvement Discuss findings with the potential of reporting up to management Employee has an individual responsibility for knowledge of and compliance with laws, regulations, and policies. Compliance is a condition of employment and is considered an element of job performance Maintain HIPAA/patient confidentiality Regular and reliable attendance as assigned by your schedule Other job duties assigned Required Qualifications: 2 years recent work history Desired Qualifications: Bachelor’s degree from accredited university (any field) Prior work experience in healthcare or health insurance What we look for We are looking for a highly motivated, talented individual with the following qualities: Detail oriented & critical thinker Excellent customer service skills High level of organization Strong decision maker Strong communicator Flexible and adaptable Empathetic, compassionate, inclusive What to expect in the first 30 – 60 days: First 30 days you will be training on: 4 major internal programs Basic & complex strategies for resolving a insurance claim denial Key metrics & KPI’s Compliance rules & regulations Training is a combination of modules + one on one with supervisors and billers After 30-45 days, you will be responsible for working an assigned billing report independently, answering phone calls independently, as well as the attending and contributing to the following meetings: Frequent one on one prioritization and Q&A sessions with supervisor Weekly all team meetings with all Urology Billing members Bi-monthly meetings with relevant support teams as needed Expect about 25% of your time to be spent collaborating; 75% of time to be spent working independently What Aeroflow Offers Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!! Here at Aeroflow, we are proud of our commitment to all of our employees. Aeroflow Health has been recognized both locally and nationally for the following achievements: Family Forward Certified Great Place to Work Certified 5000 Best Place to Work award winner HME Excellence Award Sky High Growth Award If you’ve been looking for an opportunity that will allow you to make an impact, and an organization with unlimited growth potential, we want to hear from you! Aeroflow Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

Posted 4 days ago

Acrisure logo
AcrisureJanesville, Wisconsin
Under the supervision of the Administration Manager, this position requires an individual who has the ability to work independently, can work under pressure, is analytical and has excellent problem-solving and communication skills. Location Janesville, WI Office Based Position Qualifications Requirements for this position include: A high school diploma 2-3 years of customer service experience is highly preferred Knowledge of Microsoft Office applications. Excellent computer and typing skills Some knowledge of health insurance is preferred Skills: Exceptional customer service skills Strong verbal and written skills Basic math skills Research abilities Superior organizational and advanced multi-tasking skills Qualified candidates must be punctual Ability to respond to questions in a tactful and professional manner Responsibilities Responsibilities of a Billing Specialist include but are not limited to: Handling inbound and outbound calls with customers regarding payment inquiries Processing, tracking and completing billing statements Processing cancellations requests Processing Plan Change requests Completing billing adjustments Performing data entry onto Company's business software Performs clerical tasks and other duties as assigned Subject to assisting with “Supervisory” calls Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant . To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.

Posted 30+ days ago

Sanford Health logo
Sanford HealthSioux Falls, South Dakota

$18 - $28 / hour

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: 8 Hours- Day Shifts (United States of America) Scheduled Weekly Hours: 40Starting Rate: $17.50 - $28.00 Union Position: No Department Details Monday- Friday schedule, ability to work from home after 6 months, health insurance background preferred but not required, and the ability to apply skills and knowledge from other positions to support a first-in-class member experience. Summary The Senior Premium Billing and Enrollment Coordinator serves as a subject matter expert to other team members, answering escalated billing and enrollment issues with both internal and external customers and clients. Job Description Responsible for the receiving, processing, reviewing and maintaining all types of enrollment. Performs testing for new processes and updates in systems. Monitors group inventory. Tracks and documents group set up and renewal workflow, supervises the process for timeliness and verifies accuracy of completed process. Identifies performance gaps and reports to Operations Leadership any opportunities for workflow efficiency and process improvement. Provides training and education to team members as needed. Must be detail oriented with the ability to investigate and problem solve. Relies on experiences to recognize enrollment and eligibility discrepancies. Must be able to effectively communicate, verbally and written, with internal departments and clients/members regarding enrollment processes and procedures, eligibility inquires and verification of data. Demonstrates analytical ability in processing electronic enrollment files. Assimilates large amounts of information to maintain a broad knowledge base. Exercises good judgment in determining best methods of solving problems. Maintains a positive and professional relationship with internal staff, clients, members and vendors. Maintains confidentiality. Qualifications High school diploma or equivalent required. Associate degree preferred. Two years’ experience in health insurance, healthcare billing or similar industry including enrollment and eligibility preferred. Experience with Medicare, COBRA and ERISA highly desirable. Computer proficiency required. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.

Posted 4 days ago

L logo
Law TymeOakland, California

$35 - $40 / hour

Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance A well Established California Litigation Law Firm with 5 offices across the State of California is seeking an Experienced Legal Billing & Collections Specialist to work in the Oakland Office. This position will be HYBRID once the probationary period is over; 3 days in office; 2 days out. It is REQUIRED that you have Law Firm Billing and Collections experience in order to be considered for this position. Requirements: · Minimum 3 years of experience as a Legal Billing Specialist in a Law Firm · Must have experience with Legal Billing Software and be computer savvy · Must handle confidential materials with discretion · Be organized and have skills to prioritize daily · Have experience with iManage and Excel Job Duties: · Generate monthly pre-bills, edit and finalize to send to clients · Prepare write-off request forms for approval · Utilize Excel daily and efficiently · Monitor and track Accounts Receivables to ensure collections are completed · File client-matter docs electronically and in iManage · Prepare daily deposits and post receipts · Able to complete Collection tasks Benefits: Medical, Dental, Vision, PTO, Paid Holidays, 401K and much more. Salary: $35-40 per hour, DOE For more information about the Firm and the position, please submit your Resume for consideration of an interview._ Compensation: $35.00 - $40.00 per hour Law Tyme, Inc. is owned and operated by a seasoned litigation specialist, Melissa A. Carver. Ms. Carver has worked in the legal field for many years at the capacity of a Litigation Secretary, Paralegal, Office Administrator, Temp, and now owns and operates her third legal staffing firm. Ms. Carver and her staff have worked in law firms and are qualified to place qualified candidates with the employer in need. We are a Legal Staffing firm placing Legal/Litigation Secretaries, Paralegals, Receptionists, Runners, Accounting, Management Positions, and Attorneys, in California and Las Vegas, providing quality service to our clients and candidates. We love what we do and we love to teach, educate and help people achieve their goals, whether it be the employer or the candidate.

Posted 30+ days ago

Fawkes IDM logo
Fawkes IDMWashington, DC
Responsibilities: Assist the E-Billing Manager and E-Billing team with all electronic on-boarding needs to include, client matter setup and mapping, timekeeper entry and mapping, diversity submission as required, and rate updates/maintenance in the various e-billing platforms utilized by the firm clients Transmit electronic billing via Ebilling Hub and various e-billing sites Responsible for recording and maintaining accurate phase, task, and billing codes Assist with bill preparation for more sophisticated e-bills and/or on-demand requirements as available (both manual & electronic) Maintaining and adding timekeepers to restricted lists in Time Entry software Send weekly reports to the Billing Team for un-submitted invoices and rejected invoices. Prepare invoices for usage of various e-billing sites Coordinate special client billing requests with E-Billing Manager Coordinate approval and implementation of special rate arrangements in collaboration with the Pricing and Project Management team and the Billing Compliance team Requirements 3+ years experience working in a professional services environment, law firm billing experience preferred. Experience with financial/billing software packages and Finance/Accounting organizational operations. Elite billing system experience preferred. Experience with electronic billing transmission on a variety of e-billing platforms, eBillingHub experience preferred. Ability to adhere and apply billing department policies and procedures. Proficiency in MS Office; strong knowledge of Excel required.

Posted 30+ days ago

Memorial Health logo
Memorial HealthMarysville, Ohio
We are looking for a Billing Representative to join our collaborative team at Memorial Health! What You'll Do: Billing Functions Ensures insurance claims are sent timely and accurately to government, commercial and managed care plans, adhering to payer timely filing requirements Researches and resolves claim edits via Epic Work Queues (WQ) and/or external billing software, including electronic and paper processing Prepares and processes secondary and tertiary insurance claims completing coordination of benefit tables accurately reflecting prior payer reimbursement Ensures compliance and billing requirements for Worker’s Compensation (WC) and third-party liability claims are met Ensures claims submission with all appropriate documentation, using the Release of Information (ROI) module in Health Information System (HIS) Verifies and updates patient account demographic and financial information, processing Real-Time Eligibility (RTE); contacting account guarantor and/or payer as appropriate for demographic and financial clarification Enters complete and appropriate account note(s) in HIS identifying actions taken to reconcile claims Works various hospital departments to insure all authorizations, coding and charge information is in place to expedite clams processing and accurate account reimbursement Works directly with Charge Description Master (CDM) Coordinator to insure all implanted devices are accurate and included on the claim Reviews Medicare Common Working File (CWF) to determine primary payer based on Medicare Secondary Payer Questionnaire (MSPQ), as appropriate. Accounts Receivable Management Manages account review and processing from system WQs, insures timely follow-up on all unpaid claims within appropriate billing cycle; manages system denial remark module, taking steps to rectify current denial Contacts payers via payer websites and telephone for claim status and/or clarification on denied claims Manages outstanding accounts receivable per departmental standards; maintains each payer’s outstanding receivables at or above departmental established goals Prepares and submits appeals, collecting all pertinent documentation; filing per each individual payer’s guidelines Customer Service Supports all team members and co-workers, engaging in positive interactions at all times Exhibits professional communication with customers, family members, co-workers, vendors and payers, by providing helpful assistance and responding timely to requests. Ensures active listening prior to responding, remains calm and confident when assisting others Demonstrates a strong representation of Memorial Health’s values through attitude, actions and communications with others Addresses patient concerns and complaints and provides resolution for readily resolved issues; escalates more in-depth issues as appropriate to assist with service recovery Displays enthusiasm and resourcefulness in providing assistance Critical Thinking Actively looks for and creates opportunities to improve department, staff and personal development Develops and demonstrates knowledge of current developments in field to maintain competency Utilizes hospital and departmental policies and procedures Interpersonal Acts as a resource for new employees and precepts as needed All interactions are conducted in a professional manner Demonstrates a positive attitude Provides excellent customer service, facilitates quality care delivery and fosters an atmosphere of understanding cultural diversity Communicates dissatisfaction with issues to direct supervisor; actively contributes to the solution of problems and refrain from promoting dissatisfaction among co-workers Must be a team player; cooperate with co-workers to resolve conflict through one on one negotiation or with the assistance of the Director or their designee Maintains confidentiality at all times to protect patient’s privacy and maintains HIPAA privacy and security regulations Documentation Documents accurately (painting a complete picture providing directions to other health care providers); refrains from using unapproved abbreviations in written or computer documentation Documentation is completed on a daily basis Understands the importance of accurate completion of documentation and Hospital accreditation requirements and how it impacts hospital payment and certification programs Education HIPAA privacy regulations and related procedures CMS updates on patient rights Other Exhibits behaviors reflective of Memorial’s core values: Compassion, Accountability, Respect, Excellence, and Service Demonstrates regular and predictable attendance. Attends all mandatory education and in-services (i.e., team training, safety, infection control, etc.); completes mandatory health requirements. Employee performs within the prescribed limits of the hospital’s and department’s Ethics and Compliance program and is responsible to detect, observe and report compliance variances to their immediate supervisor, or upward through the chain of command, the Compliance Officer, or the hospital hotline. Performs other duties as required or assigned. Requirements High school diploma or equivalent and three (3) years’ experience in the medical field preferably in a hospital setting. Knowledge of revenue cycle functions, understanding of health insurance and government programs, billing processes, managed care contracts, coordination of benefits with ability to interpret explanation of benefits desired. Knowledge of office practices and procedures, medical terminology and the ability to communicate effectively. Must be proficient with Microsoft Word, Excel and PowerPoint. Shift 1st Hours 80 per pay (every two weeks) Benefits Medical Insurance Dental Insurance Vision Insurance Life Insurance Flexible Spending Account Time Off Vacation Sick Leave 11 Paid Holidays Personal Day Retirement Ohio Public Employee Retirement System Deferred Compensation Other Tuition Reimbursement Kidzlink Daycare Center Employee Recognition Free Parking Wellness Center Competitive Salaries Community/Family Atmosphere Location: Approx. 25 minutes away from Dublin, OH Approx. 30 minutes away from Hillard, OH Approx. 30 minutes away from Delaware, OH Approx. 30 minutes away from Powell, OH We look forward to seeing your application! It is our commitment to inclusivity and diversity and our ongoing determination to provide a welcoming and inclusive environment for all staff and guests of the Hospital, regardless of age, color, disability, gender, gender expression or gender identity, genetic information, national origin, race, religion, sexual orientation, or veteran status. For any questions or needed accommodations, please contact Memorial Health Human Resources at 937.578.2701.

Posted 2 weeks ago

C logo
Caresense Home HealthBrick, New Jersey
At CareSense we are only as good as our caregivers.Our extraordinary caregivers provide quality Home Health assistance, bringing much relief and quality of life for our patients and their families.A BILLING - FISCAL BOOKKEEPING SPECIALIST is needed to assist in our Lakewood NJ Branch. RESPONSIBILITIES INCLUDE: Billing: · Prepares claim reports and ensures all claim data is accurate and correct · Submits claims to the appropriate payers and monitors status from submission until payment · Resolves and coordinates resolution of denied claims, by communicating with all parties involved · Resubmits corrected denied claims · Identifies and reconciles discrepancies in reimbursements · Reports issues regarding claims to appropriate individuals Fiscal: · Reviews client/staff files to ensure all information required for authorizations is present · Enters services authorizations into proprietary software ensuring correct coding and amounts · Updates authorizations as needed · Reviews care logs to ensure correct coding, unit and dollar calculations. · Reviews expense reimbursement requests · Reviews expense reports to ensure good practices are being followed · Implements cost control measures · Disburses funds for approved expenses Bookkeeping: · Enters data in Quickbooks including invoices, payments, adjustments in Quickbooks · Enters expenses, income, and reconciles bank and credit card statements · Runs reports to identify outstanding invoices and initiate collection Requirements: · Three to five years related experience and training; in-depth knowledge of billing/fiscal administration processes, procedures and best practices. · Familiarity with insurance reimbursement protocols. · Expert level proficiency in QuickBooks and Microsoft Office (Word and Excel); · Expert computer skills with the ability to utilize various advanced computer systems to support the various responsibilities · Excellent phone, interpersonal, verbal and written communication skills · Fast paced, very organized and detailed, with the ability to handle extensive amounts of paperwork/documentation · Self-directing and very independent with the ability to work with little direct supervision · Very comfortable with technology applications including personnel recruiting systems, staffing and scheduling systems, electronic medical records systems, · Reliable car, valid State driver's license and car insurance · Background check will be required · Must have authorization to work in the USA CareSense Home Health and Hospice provides superb services, including nursing, therapy, social services, and health aides.We are committed to quality care, sensitivity, and patient satisfaction. Our goal is to improve our patients' health andquality of life with professionalism and respect.To learn more about our company please visit our website at http://www.caresensehc.com

Posted 30+ days ago

A logo
American Family Care Ladera RanchLadera Ranch, California

$22 - $28 / hour

Benefits: 401(k) Bonus based on performance Competitive salary Health insurance Opportunity for advancement Paid time off Training & development Benefits/Perks Paid time off Health insurance Dental insurance Retirement benefits Employee referral incentives Great small business work environment Flexible scheduling Additional perks! Responsibilities Office administrative work HR Duties Process billing, payments, and other financial transactions Assist with medical record filing and data entry Insurance and payer follow ups Greeting patients visiting the facility, answering any questions they may have and helping them fill out the required forms Answering phone calls, creating appointments, directing the calls as required and handling all queries Maintaining a filing system for all patient documents and reports submitted Answering emails and other electronic messages as required Creating invoices and bills, processing insurance forms and managing vendors and contractors Transcribing all notes and documents related to treatments Coordinate with other departments to ensure smooth operations Assist with special projects and other administrative tasks And other Medical Office Administration and Billing tasks Qualifications Bachelor’s degree preferred - Not Required A minimum of 1 year experience medical office administration required Demonstrated skills in written, verbal, and consultative communications Ability to deliver high levels of customer service and achieve customer satisfaction Understanding of compliance and regulatory guidelines Understanding medical office admin/billing Company Overview American Family Care (AFC) is one of the largest primary and urgent care companies in the U.S. providing services seven days a week on a walk-in basis. Our state-of-the-art centers focus on the episodic treatment of acute illnesses and injuries, workers' compensation, and occupational medicine. Each location is equipped with an onsite lab and in-house x-ray capability. AFC is the parent company of AFC Franchising, LLC (AFCF). Compensation: $22.00 - $28.00 per hour PS: It’s All About You! American Family Care has pioneered the concept of convenient, patient-centric healthcare. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. Ranked by Inc. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. If you are looking for an opportunity where you can make a difference in the lives of others, join us on our mission. We invite you to grow with us and experience for yourself the satisfying and fulfilling work that the healthcare industry provides. Please note that a position may be for a company-owned or franchise location. Each franchise-owned and operated location recruits, hires, trains, and manages their own employees, sets their own employment policies and procedures, and provides compensation and benefits determined by that franchise owner. Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more. We are an Equal Opportunity Employer.

Posted 30+ days ago

Assembly Health logo
Assembly HealthChicago, Illinois

$23 - $25 / hour

Become an Assembler! If you are looking for a company that is focused on being the best in the industry, love being challenged, and make a direct impact on our business, then look no further! We are adding to our motivated team that pride themselves on being client-focused, biased to action, improving together, and insistent on excellence and integrity. What You Will Do Enter and verify patient demographics, insurance details, and charges for accuracy. Review documentation to ensure services are billable and meet payer requirements. Apply appropriate CPT, HCPCS, and ICD-10 codes based on documentation. Ensure timely and compliant submission of claims to payers. Identify and correct errors to minimize claim rejections and denials. Monitor and address charge entry-related rejections or edits in billing systems. Communicate with internal teams to resolve charge discrepancies. Assist with claim resubmissions and billing-related inquiries as needed. Maintain data integrity and confidentiality per HIPAA guidelines. Reconcile daily charge entry logs to confirm all services are captured. Other tasks as needed. What it Takes to Join the Family Minimum of two years’ experience in behavioral health billing or related field required. Including EMR/EHR knowledge (Kipu, BestNotes, highly preferred). Experience in CPT, HCPCS and ICD-10 coding. Ability to manage critical deadlines and keen attention to detail. Escalate any discrepancies to management. Excellent verbal and written communication skills Must be resourceful, persistent and possess excellent problem resolution skills. Proficient in Microsoft Office Ability to function well in a fast-paced and at times stressful environment. Prolonged periods of sitting at a desk and working at a computer. Ability to lift and carry items weighing up to 10 pounds at times. Why Assembly? Be part of something special! We are growing both organically and through acquisitions. Career growth - your next role with Assembly might not be created yet and we are waiting for your help to chart the way! Ongoing training and development programs. An environment that values transparency Competitive Benefit Packages available, Paid Holidays, and Paid Time Off to enjoy your time away from the office. This is a full-time, non-exempt position reporting to the Billing Manager. The compensation range for this position is $23 - $25 per hour. Compensation for this role is based on a variety of factors, including but not limited to, skills, experience, qualifications, location, and applicable employment laws. The expected salary range for this position reflects these considerations and may vary accordingly. In addition to base pay, eligible employees may have the opportunity to participate in company bonus programs. We also offer a comprehensive benefits package, including medical, dental, vision, 401(k), paid time off, and more.

Posted 30+ days ago

A logo
Access-Supports for LivingMiddletown, New York

$23+ / hour

Description Location: Middletown, NY Pay Rate: $23.00 + Benefits Package Hours: Monday-Friday 8:00AM-4:30PM, On-Site. Job Responsibilities: Responsible for timely completion/submission of transactions & reviewing for accuracy. Problem solves works independently, and shares knowledge with others to assist them with transactions. Responsible to post transactions on a regular basis and performs reconciliations to ensure accuracy. Independently reviews accounts to follow up on outstanding issues or coding irregularities on a regular basis. Responsible to maintain/update vendor/employee profiles and information as needed. Able to correct and update information, programs and other necessary tables independently. Responsible for tracking and reporting transactions in order to create concise managerial reports and performs account reconciliations independently in area of responsibility and assists others as needed. Understanding of basic accounting concepts to enable completion of monthly & yearly reconciliations and analysis for submission to auditors and uses knowledge to assist and train others. Has computer skills which include knowledge of Excel, Word, and database software and file maintenance. Responsible to create and design useful spreadsheets & databases independently or with minimal assistance. Organized, precise, able to display clear understanding of job responsibilities and perform various tasks and special projects assigned. Relies on experience and judgment to plan and accomplish agency’s goals and objectives. Responsible to lead and work effectively in a team environment as well as independently. Willing to assist and train others to perform a variety of job functions. Communicates effectively, openly and honestly, with staff and leaders on a consistent basis. Identifies and communicates any noted variances or changes in transaction trends and or nature to assist with expense or revenue monitoring. Maintenance of all documentation and keeping all filing up to date. Understands and can effectively back-up other position (s) within the Finance unit. Qualifications: The ideal candidate will have: Minimum 3 years’ commensurate experience required. Prior experience with Medicaid/Medicare managed care billing Behavioral Health Insurance billing knowledge Excellent problem solving skills. Excellent computer skills (Proficient in Excel). Excellent organization skills. Excellent communication skills. Can work both independently and in a team environment. Education & Experience: High School graduate. 3 years’ commensurate experience Access: Network is an EEO employer

Posted 30+ days ago

Huntsville Memorial Hospital logo

Billing and Collections Representative

Huntsville Memorial HospitalHuntsville, TX

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Job Description

Under general supervision of the Supervisor of Billing, the Billing and Collections Representative completes daily billing and AR follow up for assigned scope, in accordance with established criteria. Includes the daily reconciliation of assigned reports and controls to ensure claims are billed accurately and timely. Coordinates follow up with providers, clinic, and hospital staff as needed. Serves as the first point of contact for customer calls and inquiries regarding billing and claim payment.

Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position.

Resolves daily billed claim edits and rejections: target Clean Claim rate of 95% or greater:

  • Resolution of Electronic Billing System (EBS) client, payer, and/or clearinghouse acceptance and rejection reports
  • Monitor and follow up to identify and resolve discharged not final billed holds (DNFB)
  • Process Balance Bill claims to next payer after primary/secondary claims are accurately adjudicated
  • Accurate completion of UB04 and/or 1500 claim form/field requirements, by payer (condition, occurrence and value codes, etc.) for primary, secondary, and tertiary claims
  • Accurately interpret payer specific Explanation of Benefits (EOB) and Remittance Advice (RA) to identify claim modification and/or special billing requirements
  • Monitor and release claims to meet Timely Filing requirements
  • Review/Resolve hold claims and release to billing w/in 24 hours
  • Submit clean claims for outpatient & inpatient hospital services and Rural Health Clinics
  • Combine claims as appropriate to ensure compliance with applicable billing rules and regulations, including but not limited to:
    • CMS Payment Window Rule
    • Series Claims/Recurring Services
    • Packaged/Bundled Services
    • Worker’s Compensation
    • Department of Transportation (DOT)
    • Accident and Other Liability
    • Attorney and/or Probate
    • Balance Billing (secondary/tertiary payers)
  • Resolves denied claims: target denial rate of
    • Authorization, Pre-Certification, and Referrals
    • Other Billing Issues
    • Medical Record Copies
    • Credentialing Issues
    • Coding
    • Charge Capture
    • Medical Necessity and/or ABN Issues
  • Identify and resolve recurring provider/clinic-specific claim delays: registration demographic profile, eligibility and Iplan assignment, authorization/pre-certification/referrals, medical necessity and/or ABN, charge entry and coding accuracy.
  • Performance Improvement Opportunities: Compiles information and contributes to the trending of Bill Holds and Denials for performance improvement by Provider, by Payer & by Reason/ Reason Code.
  • Achieves daily targeted individual productivity and performance outcomes for: daily productivity, Clean Claim submission rate, & quality assurance.
  • Provides backup as needed to the Scheduling and Registration staff in the Rural Health Clinic by answering phones, scheduling, and performing patient registration.
  • Abides by the HMH Legal Compliance Code of Conduct.
  • Maintains a safe work environment and reports safety concerns appropriately.
  • Maintains confidentiality and appropriate handling of PHI.
  • Performs all other related duties as required and assigned

Requirements

  • Education: High school diploma or GED required. Graduate of a formal billing/coding program required.
  • Experience: Five years of business office experience in a healthcare setting required.
  • Required Skills: Excellent interpersonal, customer service, problem solving, and written and oral communication skills. Working knowledge of CPT codes and ICD-10 codes.

Benefits

  • Health Care Plan (Medical, Dental & Vision)
  • Retirement Plan (401k, IRA)
  • Life Insurance (Basic, Voluntary & AD&D)
  • Paid Time Off
  • Short Term & Long Term Disability
  • Training & Development
  • Wellness Resources

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