Insurance Reimbursement Specialist

At Aylo Health (formerly Eagles Landing Health), we work together to enrich the health and well-being of every life we touch. Our mission is to make quality healthcare simple and convenient. Because healthy people can do amazing things!

We offer a work environment that values the creation of lifelong relationships, while also providing opportunities for growth and career development. We strive to care for each other with the same passion with which we care for our patients. Aylo Health offers competitive pay to team members who provide high-quality care, while delivering an exceptional patient experience.

JOB SUMMARY:

The Insurance Reimbursement Specialist will be responsible for document retrieval, analysis, claim processing, and reimbursement.

ESSENTIAL FUNCTIONS:

• ICD diagnosis coding, modifier application and verification of CPT and/or HCPCS codes
• Responsible for ensuring all claims processed through EMR are correct and compliant
• Ensure all assigned charts are audited and billed; ensure that all billable charges are entered into billing system
• Keeps abreast of and complies with coding guidelines and reimbursement reporting requirements.
• Daily review and follow up on all incomplete electronic provider-billing encounters.
• Ability to identify issues, correct code and/or pend due to missing information.
• Apply in depth knowledge of coding principles to validate missing or incomplete CPT, HCPCS, or ICD-10 codes.
• Appropriate assignment of diagnosis codes to CPT codes.
• Review and completion of claim edits
• Review of Denials including writing appeals and facilitating their submission.
• Ability to maximize reimbursement for claims.
• Ability to run standard reconciliation reports.
• Other duties as assigned

QUALIFICATIONS REQUIRED:

• High School graduate or equivalent required
• Preferred but not required: AHIMA
• A minimum of 3-5 years of medical ICD & CPT coding experience, Family Practice or Clinic setting is preferred
• Electronic Medical Record experience, eCW software highly preferred
• Excellent communication skills
• Problem solving skills
• Computer literate with entry level working knowledge of Microsoft Suites; Outlook, Word
• Demonstrated ability to organize, coordinate, prioritize, and facilitate many on-going tasks at one time
• Duties require professional verbal and written communication skills
• Ability to work independently or with a team
• Professional appearance
• Positive attitude

We offer our employees a comprehensive benefits package that includes:

• Medical insurance with prescription drug coverage
• Dental insurance
• Vision insurance
• Company-paid child care
• Company-paid basic life insurance
• 401(k) with company match
• Dependent Care Flexible Spending Account
• Healthcare Flexible Spending Account
• Paid time off

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Aylo Health is an Equal Opportunity Employer