Medical Billing Collector Ii

Job Description:

The Medical Billing Collector is responsible for the collections, follow up and appeals of insurance claims. Essential to this position is the ability to manage all insurance follow up for maximum insurance reimbursement. To include outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials and resolving unpaid claims.

Qualifications:

• Minimum Education: High School Diploma/G.E.D.

• Minimum 3+ Years of experience with insurance collections and follow up.

• Knowledge of both In Network and Out of Network Facility and Physician Claims.

• Knowledge of HIPAA, healthcare regulations and compliance

• Positive attitude, Team player and ability to work independently.

• Must have understanding of Revenue Cycle, Claims Processing and Denial Resolution.

• Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans and Humana.

• Experience in preparing and submitting claims, facility, physician and specialist.

• Experience in reading, analyzing and interpreting EOB’s from various insurance providers is a must.

• Familiarity with identifying claims in need of appealing, and the appeals process

• Ability to have clearly communicate claim follow up and appeals status with insurance company representatives.

• Demonstrates excellent problem-solving skills and negotiating skills.

• Proven experience in a production-based environment with concentration on meeting production standards.

• Knowledge of EPower and Centricity desired.

• Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer systems applications.

• Type 45-60 WPM.

Job Responsibilities / Duties:

• Performs various collection actions including correcting & resubmitting claims to insurance, filling appeals, A/R reports.

• Understand and stay informed of changes with procedures, billing guidelines, and laws for specific insurance carries or payers.

• Research, appeal, and resolve unpaid insurance claims.

• Initiating collection follow-up on all unpaid or denied claims with appropriate insurance carrier.

• Actively follow up and collect on all electronic claims, including resolution of any billing errors assigned following established procedures.

• Respond to correspondence from insurance carriers.

• Work assigned claim volume timely and efficiently within corporate timeframes.

• Maintains multiple spreadsheets for different project tracking.

• Experience with NSA/IDR & is preferred

• High call Volume in both outbound and inbound calls for claim status

Working Conditions:

• Frequent speaking, listening using a headset, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer.

• Service center with moderate noise level due to representatives talking, computers, printers, and floor activity.

• While performing duties of this job, the employee is frequently required to stand, walk and sit.

Must submit to random drug screenings.

RoundTable Medical Consultants does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, national origin, marital status, citizenship status, physical or mental disability or veteran status.

The above job description is intended to describe the general content of and requirements of the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

The statements in this job description are intended to describe the essential nature and level of work performed by the employee assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties & skills required of this position so classified.

Job Type: Full-time

Pay: From $21.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Houston, TX 77077: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person