Medical Billing/AR Specialist - (English/Spanish)
About The Position
As a digital transformation company -- and Great Place to Work certified -- Sutherland has been helping customers globally achieve greater agility and transform automated customer experiences for over 35 years. We work with some of the world’s most known brands in dozens of industries, including Banking & Financial Services; Insurance; Communications, Media & Entertainment; Healthcare; Retail & Consumer Packaged Goods; Technology; Travel, Transportation, Hospitality & Logistics; and Mortgage Services, helping them to better support and serve their customers. 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. 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
- Bilingual in English/Spanish
- 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.
- This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.
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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
