Part Time Biller/Admin support

About us

We are professional, agile and innovative. Congenial healthcare is a privately run healthcare organization that prides itself on patient satisfaction, high standards, and ensuring our employees are thoroughly supported throughout their career. We are a unique group that are growing and need to add members to our team.

Our work environment includes:

• Flexible schedule, after training majority of time can be work from home, with some in office time when needed.
• Growth opportunities

Under general supervision from the Physician Organization team. Thorough understanding of CMS/Medicare regulations, as well as technical knowledge of medical billing and coding descriptions (International Classification of Disease (ICD-10) and Current Procedural Terminology (CPT-4) classification systems). Works closely with the physicians/providers to review diagnosis and procedural codes to ensure compliant coding/billing of office-based services (i.e., Specialty Services, Mental & Behavioral Health, Other programs).

Monitors and reviews medical records to assure the accuracy of medical coding for diagnoses and procedures as well as physician signatures.

All medical billing are and respective reports are submitted and generated through EPIC EHR.

Job Functions

● Performs all job functions in compliance with applicable federal, state, local and company policies and procedures.

● Ensure timely accurate information is entered to generate professional claims from the EPIC EHR system to third party payers.

● Keep accounts receivable days minimal ensuring reimbursement through third party payors, insurance companies and patients until account balance equals zero.

● Confers with front desk staff to correct and obtain patient information, Determine the task; i.e.. checking eligibility, subscriber DOB, incorrect, policy number, Other missing information, etc.

● Work No Response WQ for unposted or denied claims to accurately reflect outstanding accounts receivable.

● Work Follow Up WQ which are denials from insurance companies, the nature of the denial determines the task i.e.., no referral/authorization, max benefit exceeded, missing inaccurate modifiers, new patient vs est. patient, etc.

● Resubmit corrected claim for appeal with appeal limits.

● Ensures that ICD-10 and CPT codes are aligned to maximize reimbursement.

● Prepare and send self-payment statements.

● Communicate effectively and respectfully with all internal and external customers.

● Answer incoming telephone calls/emails/correspondence from patients, third party vendors and internal customers and assist with other “customer” service issues.

● Respond to customer concerns in a courteous and timely manner.

● Make any necessary system corrections to the patient's account.

● Generate AR and productivity reports and distribute to appropriate staff

● Perform administrative and data entry support as required, including quality work

● Remains knowledgeable and current on third party billing, follow-up and collection applications, as well as regulatory guidelines at the federal, state and local levels

● Completes all necessary research to provide patients and/or physicians with clear and accurate account information.

● Research / correct billing rejections and denied claims

● Track payments

● Following up with patients and insurance companies about outstanding bills.

● Make any necessary system corrections to the patients account

Specialty work:

• Obtains prior authorizations and referrals for outpatient visits/procedures
• Admin assistant to all specialty services
• Billing for Specialty providers (Currently Plastic Surgery, Behavorial Health and Endocrine)

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Minimum Requirements

● Education: High school graduate or equivalent.

● 3-5 years billing experience

● Knowledge of third party payor rules, with requirements for billing and collections

● EPIC experience highly preferred.

Skills and Experience

● Experience in Mental Health/Specialty billing favorable.

● Thorough knowledge of medical terminology, ICD-10-CM and CPT4 coding necessary.

● Understanding of both the medical and business side of healthcare operations.

● Highly organized, self-motivated, detail-oriented, and energetic team player.

● Ability to multi-task in a fast-paced environment.

● Excellent verbal and written communication skills.

● Must be detail oriented.

● Strong computer skills including MSOffice, Internet, and E-mail.

● Excellent problem-solving abilities, interpersonal skills, and critical thinking.

● Experience in Mental Health/Specialty billing favorable.

Job Type: Part-time

Pay: $20.00 - $25.00 per hour

Expected hours: 28 per week

Benefits:

• Flexible schedule

Schedule:

• Day shift
• Monday to Friday

Work setting:

• Hybrid work
• Medical office
• Office
• Private practice

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Hybrid remote in Peabody, MA 01960