Medical Billing/AR Specialist - Remote

Sutherland • Clifton, NJ

7h • Remote

About The Position

In this position, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed or sent to Legal. This will include conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or online, providing ongoing appropriate collection activity on appeals, requesting additional information from Patients, Medical Records, and others as needed, communicating with insurance plans and researching health plans for benefits and types of coverage, reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed, and handling other duties as assigned.

Requirements

• Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies
• Full understanding of Managed Care collections
• Familiarity with terms such as MMC, HMO, PPO, IPA and Capitation and how these payers process claims
• Knowledge of Managed Care contracts, Contract Language and Federal and State requirements
• Intermediate understanding of Hospital billing form requirements (UB04) and HCFA 1500
• Medical claims and/or hospital collections experience
• Minimum high school education, technical training, and/or other related experience
• Excellent Internet connectivity: Internet access speeds of at least 5 Mbps upload and 30 Mbps download – the faster the better!
• In-house network, and a hard-wired Internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (wireless and/or satellite Internet Service Providers are not compatible with our systems)
• A quiet and distraction-free, secure place to work.

Responsibilities

• Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or online
• Providing ongoing appropriate collection activity on appeals
• Requesting additional information from Patients, Medical Records, and others as needed
• Communicating with insurance plans and researching health plans for benefits and types of coverage
• Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed
• Handling other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED