Billing Lead

Prime Healthcare•Mesquite, TX

1d•Onsite

About The Position

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Dallas Medical Physician Group, affiliated with Dallas Medical Center, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Requirements

Knowledge of multiple insurance billing requirements
3-5 years of billing experience
Knowledge of HIPAA confidentiality requirements, maintains strictest confidentiality.
Knowledge of Epic, Excel, Word, and clearinghouse software.
Knowledge of CPT, HCPCS, ICD-10 coding protocols, Medicaid, third party and Medicare billing and coding.
Knowledge of regulatory standards appropriate for position.
Ability to understand and apply applicable rules, regulations, policies and procedures.
Ability to communicate effectively.
Ability to establish and maintain effective working relationships with clinicians and patients.
Ability to multi-task, prioritize needs to meet required timelines
Analytical and problem-solving skills.
Customer Services experience required
High School Graduate or GED equivalent Required

Responsibilities

Bill all insurance companies, workers’ compensation carriers, as well as HMO/PPO carriers.
Audit records to ensure proper submission of services prior to billing charges.
Submit claims for provider visits to third party insurance carriers.
Receive hospital information to properly bill provider services for hospital patients.
Design and implement processes surrounding proper coding of medical claims.
Review diagnosis and procedure coding within Epic.
Review charts and provide one-to-one educational feedback to the clinicians.
Educate business, clinical staff and providers on payer specific policies and general coding guidelines.
Process rejections by either making accounts private and generating a letter of rejection to patient or correcting any billing/coding errors and resubmitting claims to third-party insurance carriers.
Secure needed medical documentation required or requested by third party insurance.
Follow up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
Stay current with legal and regulatory changes, and local and national trends, in coding.
Keep abreast of changes in third party reimbursement procedures.
Answer questions from billing employees, patients, front office staff and insurance companies.
Identify and resolve patient billing complaints.
Assist with process creation and implementation.
Assist with insurance credentialing and recredentialing.
Assist with facility credentialing and recredentialing.
Train and supervise billing staff to improve performance and ensure compliance with policies.
Monitor daily operations, including charge entry, claim submission and payment posting.
Prepare and analyze AR reports on a monthly basis.
Attend departmental and other meetings as assigned by supervisor.
Provide backup when needed.
Perform other related duties, which may be inclusive, but not listed in the job description.