Medical Billing Specialist II - USA - TX - Remote

Teladoc Health is a global, whole person care company made up of a diverse community of people dedicated to transforming the healthcare experience. As an employee, you’re empowered to show up every day as your most authentic self and be a part of something bigger – thriving both personally and professionally. Together, let’s empower people everywhere to live their healthiest lives.

Position Summary

The Medical Billing Specialist reports to the Supervisor of Revenue Cycle Billing and will be responsible for a variety of tasks requiring data analysis, knowledge of insurance and billing regulations, client and health insurance contracts to support reimbursement and collections methodology. This individual will focus on maintaining quality of medical billing for insurance verification, claim edits and claim processing. This individual will work closely in coordination with RCM (Revenue Cycle Management) leadership to ensure billing productivity and quality metrics are met for reimbursement and AR follow up.

Role and Responsibilities

  • Meet department production and quality standards
  • Meet project and assignment due dates and deadlines
  • Knowledge of client contracts and unique billing requirements for Teladoc Health entities
  • Manage inbound calls from members / internal service partners that are related to claims adjudication issues
  • Research and resolve any open requests for either insurance and/or member refunds
  • Escalates claim resolution to management when necessary
  • Review all patient information and postings, prior to claims submission
  • Submit claims to insurance carriers
  • Analyzing denials and outstanding claims to determine appropriate remediation actions to resolve root causes and reduce/eliminate denials 
  • Follow up to see if claims are accepted or denied
  • Investigate rejected claims, denial resolution review
  • Verify insurance coverage and maintain accurate member eligibility status in our database
  • Help automate existing processes and learn …

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