Sr Medical Biller

Started in 2016, FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. We bring dignity and support to patients needing care in their homes and to the caregivers who care for them. We're the largest consumer-directed home care agency in NY State, and are continually expanding our areas of focus including operations in other states and tech-based innovations.

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a Sr Accounts Receivable Specialist to join our Physician Practice.

This role is remote with potential travel to our main office in New York and/or the FreedomCare hub closest to you.

Department & Position Overview:

FreedomCare Med is seeking a skilled Senior AR Specialist to lead interactions with all in-network insurance carriers.

Seeking an accomplished AR Specialist with expertise in Medical Billing, renowned for reducing claim denials and enhancing revenue cycle efficiency. Instrumental in implementing and championing Electronic Health Record (EHR) system.

Proven track record claim submissions for multiple providers and maintaining close collaboration with healthcare providers. Possesses extensive experience in both private practices and large healthcare systems, making a valuable addition to our team at FreedomCare Med.

This pivotal role involves advocating for providers and clinicians supporting primary care/internal medicine practices and healthcare programs like RPM, CCM, and BHI and ensuring all timely coding and billing procedures.

Every Day You Will:

Join our team as a Senior AR Specialist, leading interactions with in-network insurance carriers to ensure timely and accurate payments for healthcare professionals involved in various programs, while celebrating victories in resolving payer denials.

• Claim Submissions:
  • Prepare and submit claims for medical services provided by the practice's 5 providers
  • Ensure accuracy in claim submissions, verifying patient demographics, coding, and procedural information
• Billing Requirements Scrubbing:
  • Scrub claims thoroughly to ensure compliance with billing requirements, including accurate coding and documentation
• Validate insurance information, authorizations, and other necessary details prior to submission
• Denial Analysis:
  • Analyze claim denials to identify root causes and trends.
• Collaborate with internal teams to address and rectify issues contributing to denials
• Adjusted Claims Processing:
  • Process adjusted claims promptly in response to feedback from payers or changes in billing requirements.
  • Ensure that adjusted claims adhere to updated coding and documentation standards.
• Fee Schedule Changes and Contracted Rates:
  • Monitor and capture changes in fee schedules for all relevant payers.
  • Stay informed about contracted rates with insurance providers and update billing practices accordingly.
• Subject Matter Expert (SME):
  • Serve as the Subject Matter Expert on all aspects related to claims and payments.
  • Provide guidance to team members and other stakeholders regarding billing processes and best practices.
• Communication and Collaboration:
  • Collaborate with providers, clinicians, and internal staff to address billing inquiries and discrepancies.
  • Maintain open communication with insurance carriers to resolve issues and optimize reimbursement.
• Training and Development:
  • Provide training and support to junior billing staff on effective claim submission and denial resolution strategies.
  • Stay updated on industry changes and disseminate relevant information to the team.

Ideal Candidate Will Possess:

• Required Certificates:
  • Medical Billing and Coding Certification: Required for proficiency in accurate coding and billing practices.
  • Healthcare Compliance Certification: Required for ensuring adherence to regulatory guidelines.
• Preferred Certificates:
  • Certified Revenue Cycle Specialist (CRCS): Required for a strong foundation in revenue cycle processes.
  • Certified Professional Coder (CPC)
  • Certified Professional Biller (CPB)
• Athena EMR Experience:
  • Demonstrated proficiency and hands-on experience with Athena Electronic Medical Records (EMR) system.
• Healthcare Program Billing Expertise:
  • Proven experience in billing for healthcare programs, including Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Behavioral Health Integration (BHI).
• Medicaid and Medicare Experience:
  • Specific expertise in billing for Medicaid and Medicare programs, ensuring compliance with government regulations and optimizing reimbursement.
• Understanding of Fee Schedules:
  • Comprehensive knowledge and experience in capturing and adapting to Fee Schedule changes for various insurance carriers.
• Contracted Rates Negotiation:
  • Experience in negotiating and managing contracted rates with insurance providers for optimal reimbursement.
• Communication Skills:
  • Excellent communication skills to collaborate with internal teams, including the finance team, healthcare providers, and management.
• Team Collaboration:
  • Proven ability to work collaboratively with departments such as finance, providers, and management to address billing inquiries, discrepancies, and process improvements.

Why work at FreedomCare?

We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.

This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.

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