The Onyx Group - Medical Reimbursement Specialist

Job Title:Medical Reimbursement Specialist (AAPC Certification Not Required)
Supervised by: Coordinator, Billing
Location: Greer
Weekly Hours: Full-Time

• Are you interested in Medical Billing?
• Can you read an EOB?
• Are you known for your diligence and follow through?
• Do you love solving puzzles and feel at your best when you resolve an issue?

Position Overview
The Onyx Group is seeking an experienced individual who is highly accurate and motivated. The ideal candidate will have a strong background in medical billing, with the skills necessary to improve our current billing procedures and reduce A/R days. This individual will perform high-volume billing functions and administrative tasks. You must be comfortable working in a fast-paced environment.
This position is responsible for following up on unpaid claims, utilizing monthly aging reports, filing appeals when appropriate to obtain maximum reimbursement, verifying and submitting accurate corrected claims, and establishing strong relationships with patients, insurance representatives, and insurance companies.
Responsibilities

• Ensures all assigned claims are processed and paid with a goal of zero errors.
• Utilizes desk phone, clearinghouse, etc. to correct claim denials and rejections.
• Reads and interprets insurance explanation of benefits.
• Timely follow up on insurance claim denials, meets deadlines, and utilizes monthly aging report to follow up on unpaid claims aged over 30 days.
• Makes necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies. Submits appeals when appropriate for reimbursement.
• Responds to inquiries from insurance companies, patients, and providers.
• Regularly meets with team members and manager to discuss and resolve reimbursement issues or billing obstacles. Participates in educational activities and attends department meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations; also conducts self in accordance with the Tribe employee handbook.
• Actively demonstrates an overall desire to practice the Tribe Way through humility, and exemplify a servant's attitude towards others in the department, company, and patient population. Works to maintain integrity and excellence in every area of the job description and show initiative towards others by practicing conscious leadership in the role.

Education
High School Diploma or equivalent. Prefer experience in medical billing and coding or medical insurance; however, physician practice experience in lieu of education will also be considered.
Skills/Experience

• Knowledge of medical billing/collection practices, basic medical coding, and third-party operating procedures and practices
• Must have strong attention to detail and customer service skills
• Must be able to multi-task and work efficiently in a fast-paced work environment
• Strong Microsoft Office and computer skills
• Ability to operate a multi-line telephone system
• Skilled in patient communication with a pleasant and helpful manner as well as the ability to establish and maintain effective working relationships with patients, employees and the public
• Our Tribe513 Providers do their own coding, so a coding certificate is not required

Environment/Working Conditions:
Normal office environment. Occasional overtime may be required and/or hours may be shortened as business needs dictate.
Physical Demands
Requires sitting and standing associated with a normal office environment. Manual dexterity is needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Working conditions, skills and responsibilities may change as needs evolve.