FreshRemote.Work

Medical Billing and Appeals Specialist - Hybrid

Austin, TX, US

Description

REMOTE - this position will be fully remote after training. **Texas residents only***

Job purpose

  • The Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount and/or non-payment.

Duties and responsibilities

  • Reviews and appeal unpaid and denied claims
  • Attaches appropriate documents to appeal letters
  • Researches and evaluates insurance payments and correspondence for accuracy
  • Logs appeals and grievances, and tracks progress of claims
  • Keeps up-to-date reports and notates any trends pertaining to insurance denials
  • Calls insurance companies to inquire about claims, refund requests and payments
  • Manages Accounts Receivable reports for the Billing Department
  • Utilizes EMR system to submit and correct claims
  • Posts patient and insurance payments
  • Sends paper claims to insurance carriers
  • Answers patient billing questions
  • Coordinates medical and billing records payments with patients and/or third-party payers
  • Handles collections on unpaid accounts
  • Identifies and resolves patient billing complaints
  • Answers phone calls to the Billing Department in a timely and professional manner
  • Processes credit card payments over the phone and in person
  • Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
  • Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
  • Operates standard office equipment (e.g. copier, personal computer, fax, etc.).
  • Has regular and predictable attendance
  • Adheres to Advanced Pain Care’s Policies and procedures
  • Performs other duties as assigned


Requirements

Qualifications

Education: Requires a high school diploma or GED

Experience: Three or more years related work experience of training

Knowledge, Skills and Abilities:

  • Clear and precise communication
  • Ability to pay close attention to detail
  • Effectively manages day by organizing and prioritizing
  • Possesses excellent phone and customer service skills and abilities
  • Protects patient information and maintains confidentiality
  • Knowledge of general medical terminology, CPT, ICD-9 and ICD-10 coding
  • Familiarity with analyzing electronic remittance advice and electronic fund transfers
  • Experience interpreting zero pays and insurance denials
  • Competence in answering patient questions and concerns about billing statements
  • Organizational skills and ability to identify, analyze and solve problems
  • Works well independently as well as with a team
  • Strong written and verbal communication skills
  • Interpersonal/human relations skills

Working conditions

Environmental Conditions: Medical Office environment

Physical Conditions:

  • Must be able to work as scheduled – typically from 8:00 – 5:00 M-F
  • Must be able to sit and/or stand for prolonged periods of time
  • Must be able to bend, stoop and stretch
  • Must be able to lift and move boxes and other items weighing up to 30 pounds.
  • Requires eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.
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Job Profile

Regions

North America

Countries

United States

Restrictions

Texas Texas residents only

Benefits/Perks

Fully remote Fully remote after training Professional development opportunities

Tasks
  • Answer patient billing questions
  • Coordinate payments
  • Handle collections
  • Handle correspondence
  • Manage insurance denials
  • Post payments
  • Review claims
  • Track claims progress
  • Write appeals
Skills

Billing Claims management Clinical Documentation Collections Communication CPT coding Customer service EMR System EMR systems ICD-10 ICD-10 Coding ICD-9 Icd-9 coding Insurance denials Medical Billing Medical terminology Organizational Problem-solving

Experience

3 years

Education

GED High school diploma

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9