Provider Practice Billing & Claims Specialist
About The Position
Do you have experience with medical billing and coding? Do you have a keen eye for detail and a passion for accuracy? A Provider Practice Billing & Claims Specialist in our small office team will play a vital role in ensuring smooth, efficient billing processes that directly impact patient care. Join Maine’s newest on-site primary care team and help shape the future of senior healthcare with Evergreen Senior Healthcare of Maine. We deliver comprehensive, personalized medical care exclusively to residents of Woodlands Senior Living communities, ensuring seniors receive exceptional care delivered with dignity, respect, and heart. Composed of ten companies across the great state of Maine, Woodlands Senior Living provides a residence for more than 700 seniors to age gracefully, happily, and comfortably surrounded by compassionate caregivers. All ten of those companies have become the first in Maine to receive Joint Commission accreditation! This is your chance to combine your expertise with a mission-driven environment where your work will make a positive impact on the lives of over 600 Maine seniors. What you will do as a Provider Practice Billing & Claims Specialist: Utilizes clinical and coding knowledge to ensure accurate and compliant diagnostic and procedural assignments are captured to optimize reimbursement for professional charges, utilizing ICD-10-CM, CPT-4 and sequencing best-practices. Submits accurate and timely claims to payors. Receives payments from payors and performs data entry of payments and account adjustments. Informs Accounting Supervisor of accounting discrepancies. Performs error analysis for denied claims and provides recommendations for process improvements and claim reimbursement resolution. Escalates concerns to Accounting Supervisor. Acts as liaison and subject matter expert to internal and external stakeholders, delivering expert guidance and training related to coding systems, required documentation, payer requirements, and industry standards. This is a 20 - 24 hour position.
Requirements
- Two or more years of previous experience as a medical biller/coder preferred
- Proficient with Microsoft Office products preferred.
- Must provide proof of immunization/immunity to MMR, Varicella and Influenza
- A current, valid license to operate a vehicle in the state of Maine and a driving record that is satisfactory to the company may be required
- Strong command of the English language with the ability to follow oral and written instructions with precision
Responsibilities
- Utilizes clinical and coding knowledge to ensure accurate and compliant diagnostic and procedural assignments are captured to optimize reimbursement for professional charges, utilizing ICD-10-CM, CPT-4 and sequencing best-practices.
- Submits accurate and timely claims to payors. Receives payments from payors and performs data entry of payments and account adjustments. Informs Accounting Supervisor of accounting discrepancies.
- Performs error analysis for denied claims and provides recommendations for process improvements and claim reimbursement resolution. Escalates concerns to Accounting Supervisor.
- Acts as liaison and subject matter expert to internal and external stakeholders, delivering expert guidance and training related to coding systems, required documentation, payer requirements, and industry standards.
Benefits
- Vacation and holiday pay because you deserve time to relax and recharge
- Tuition assistance because we believe in the investment of your growth and success
- Health, dental, vision and supplemental benefits to support your health
- 401(k) savings and investment plan to prepare for your future
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
101-250 employees
