Medical Biller And Coding Examiner

About Us

All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 410k plan. Additional employee paid coverage options available.

Job purpose

The Medical Biller and Coding Examinerworks with other billing staff to ensure accurate and timely payment of professional medical claims. They will be responsible for payment posting, cash reconciliation, and overpayments. Daily duties will include performing research, analysis, cash reconciliation, payment posting, and communication with insurance and providers. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with clients and various insurance agents.

Duties and responsibilities

· Provide timely and accurate follow up on unpaid insurance claims using insurance portals, secure email, secure chat, and phone calls.

· Process incoming correspondence from insurance companies and respond or route accordingly.

· Communicate with providers to obtain required documentation and submit it to insurance companies.

· Process incoming payments from insurance companies and Health Savings Account administrators via 835 file or paper remit.

· Review payments posted by automated process to ensure accurate posting of corrections, retractions, reversals, and recoupments.

· Work with Medical Appeals and Denials Examiner to review overpayment requests and determine next steps and ensure refunds are issued as needed.

· Complete daily cash reconciliation of incoming payments, balancing payments received with 835 posting to ensure all payments are accurately captured and reported.

· Investigate and locate missing payments in collaboration with IPA staff.

· Achieve maximum reimbursement for services provided.

· Use insurance company websites to research coding and payment policies.

· Use worklist and status codes to track claims for follow up.

· Use SQL to create daily lists and reports.

· Respond to questions from insurance companies, governmental agencies, providers, and IPA management.

· Observe and report new trends and/or problems with billing and/or payment systems.

· Flexible in taking on new work assignments and working in new processes.

· Conduct duties in a professional and timely fashion.

· Conduct audits.

· All other assignments are directed by the Billing Manager.

Qualifications

· A minimum of 2 years’ experience as a medical payment poster or similar role.

· Solid understanding of billing software and electronic medical records.

· Thorough knowledge of healthcare benefits, coordination of benefits, referral and authorization requirements, and insurance follow up.

· Proficient with CPT Codes, ICD-10 Codes, Modifiers, and CCI edits.

· EZ-Cap experience preferred.

· Epic experience preferred.

· Clearinghouse experience preferred.

· Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe

· Detail oriented and highly organized

· Strong ability to multi-task, project management, and work in a fast-paced environment

· Strong ability in problem-solving

· Ability to self-manage, strong time management skills.

· Ability to work in an extremely confidential environment.

· Strong written and verbal communication skills.

Education and Additional Requirements

· Bachelor’s Degree (or in progress) in Business Administration or Healthcare Administration preferred; experience considered in lieu of degree.

Working conditions

· This job may require flexible work hours due to the nature of the responsibilities.

· The candidate must be comfortable with ambiguity and open to working in a collaborate environment.

Physical requirements

· Sitting/standing for extended periods of time.

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Remote

Work Location: Remote