Medical Billing Specialist - Remote | WFH
Are you a detail-oriented professional with experience in Revenue Cycle Management? We're seeking a dedicated Patient Account Representative II to join our team. Your expertise in handling denials and appeals will be invaluable as you help us ensure efficient claims processing and resolution. If this sounds like you, we'd love to hear from you!
Key Responsibilities
Analyze and Resolve Denials: Carefully review denials to determine the best strategy for appeal or resubmission. Use your skills to ensure that all claims are handled promptly and accurately.
Prepare and Submit Appeals: Craft accurate and compliant appeal documents for denied claims. Ensure all necessary information is included to maximize the chance of a successful outcome.
Collaborate with Team Members: Work closely with billing, coding, and clinical staff to gather all necessary information for appeals. Help resolve denial issues quickly and efficiently.
Maintain Detailed Records: Keep comprehensive records of all denial cases, including filed appeals and communications with insurance representatives.
Monitor and Follow Up: Track the status of appealed claims and maintain communication with insurance representatives to ensure timely resolution.
Analyze Trends and Improve Processes: Generate and evaluate reports on denial trends. Identify root causes and recommend process improvements to minimize future denials.
Qualifications
Education & Experience: High school diploma or equivalent required. At least 2 years of recent experience in claims processing and denials management. Minimum 1 year of experience working with the EPIC EMR system.
Skills
Ability to analyze denial reasons, identify trends, and develop strategies to reduce denials.
Strong written and verbal communication skills for effective interaction with both internal staff and insurance representatives.
Meticulous attention to detail and accuracy in documentation and appeals submissions.
Ability to collaborate effectively with multidisciplinary teams to achieve shared goals.
Thorough understanding of billing regulations, coverage guidelines, and the appeals process.
Physical Requirements
Work Environment: Predominantly sitting (90%) with some standing/walking (10%).
Activity Requirements
Occasionally lifting/carrying supplies and paper up to 40 pounds.
Occasionally pushing/pulling to move supplies and equipment.
Occasionally climbing stairs to access different building levels.
Occasionally stooping/kneeling/bending/crouching for filing and paperwork.
Frequent use of hands for paperwork, computer use, and telephone communication.
Regular talking/hearing/seeing to interact with team members and complete tasks.
Environmental Conditions
Work primarily inside, with options for onsite or remote work arrangements.
Employment Type: Full-Time
Human Resources Services
Health Care Provider
Full-time