Job description

Job Summary:

We are a high volume Multi-Specialty clinic located in Lancaster, CA. We are looking for a Medical Biller/AR specialist who has excellent communication skills and superb attention to detail to join our Team.

Must have previous experience in all the following areas:

• Investigate and resolve insurance denials in a professional and timely manner within contractual time limits.
• Have a clear understanding of the differences in medical necessity appeals and claim appeals.
• Works appeal from beginning-to-end, which includes tracking, monitoring, documenting and resolving.
• Responds to insurance denials and requests for additional information with minimal direction.
• Responsible for interface with management and providers as required regarding status, process and outcomes of appeals.
• Prepares all appeal written documentation.
• Documents all appeals in an accurate and timely manner per policy, related follow-up activities and final outcomes in designated systems while concurrently maintaining secure, comprehensive and clearly defined files.
• Read and comprehend appeal and grievance correspondences and reach out to appellant and or griever to obtain additional information as needed.

Performs daily activities such as: * Works accounts receivable for insurance on a daily basis

• Correct and re-bill denied insurance claims
• Researching return mail from insurance carriers, correct and re-sending mail
• Research and appeal denied claims
• Performs thorough benefit investigation
• Work claims and claim denials to ensure maximum reimbursement for services rendered
• Research and resolve insurance refund requests and retractions
• Assist with patient inquires regarding their insurance balance
• Always maintain a professional attitude and appearance via in person or phone. Notify supervisor immediately with any problems.

Additional responsibilities: * Assist other employees with any additional work when idle

• Performs work of equal skill, effort and responsibility as directed
• May perform work of a higher level in preparation for increased responsibility
• Must be willing to perform any duties asked by management or physicians
• Cross trained to fill in other positions when short staffed

Knowledge, Skills and Abilities * ICD-10/CPT knowledge.

• Knowledge of medical terminology & medical insurance.
• Ability to type accurately and comfortable with computers.
• Become a key contributor to the enhancement of the quality of patient care as a necessary part of a medical team.
• Understand and observe legal concepts (e.g. HIPAA, confidentiality).
• Multi-task efficiently and effectively as required.
• Work under pressure, within time constraints.
• Must be able to act calmly and effectively in a busy or stressful situation.

Physical Requirements: * Ability to stand, sit, walk, bend and stoop for prolonged periods of time, intermittently throughout an 8 hour shift.
Education and Experience: * Minimum of 2 years medical Billing experience required.

Job Type: Full-time

Pay: $16.00 - $21.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• ICD-10: 1 year (Required)
• Medical Billers & Coders: 5 years (Required)

Work Location: In person

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