Medical Billing Specialist

Careforth•Boston, MA

57d•Remote

About The Position

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond. Reporting to the Director of Healthcare Revenue Cycle Management, the Billing Specialist will handle all functions related to the collection of necessary claim documentation, claim submission, collections, and follow through on outstanding claims and cash applications. This individual will process all transactions relating to delinquent accounts, special adjustments, and/or write-offs, ensuring a smooth and accurate billing process. This individual will also lead regular cross functional meetings regarding consumer liability accounts, resolving billing and payment issues as needed.

Requirements

3-5 years in medical billing field; Knowledge/experience working with billing and payment cycles for medical accounts and analyzing accounts receivable reports is strongly desired
Strong data entry skills required; must possess exceptional attention to detail and prioritization skills
Working knowledge of insurance processes and terminology, including an understanding of EOBs, copays, coinsurance, deductibles, spenddowns, denial codes, and cost shares
Strong organizational, communication and analytical skills
Proficient in MS Office (particularly Excel) and medical billing software, with ability to work across multiple spreadsheets and systems
Ability to multi-task in a changing and fast paced environment

Nice To Haves

Experience working with Medicaid, private insurance, insurance verification, authorization and reimbursement preferred

Responsibilities

Gather all information necessary to process consumer insurance claims; ensure billing accounts, patient demographic and insurance information are set up and entered accurately
Prepare and analyze reports, ensuring billing deadlines are met; identify root causes of the claims not being paid on time
Lead meetings with cross-functional teams regarding consumer liability accounts; resolve billing and payment issues as needed
Monitor, track, and report on self-pay balances using the billing system; identify issues, and recommend necessary actions
Post 835 payment files to the billing system and edit any unmatched payments to post
Research and resolve billing discrepancies; resubmit rejected and denied claims if necessary, working with payers to resolve outstanding claims issues as needed
Audit file submissions and work through any variances, collaborate with management team as needed
Perform other duties as assigned