This role is remote; however, we are only accepting applications from Michigan residents. Candidates must be available to come onsite to the Leffingwell office in Grand Rapids for the first 4 weeks of training* 1,000 Sign on bonus for External candidates
EXTERNAL CANDIDATES ELIGBLE FOR SIGN ON BONUS
POSITION SUMMARY
Responsible for patient customer service, insurance and patient payment posting, account receivable review, resolution of unpaid and denial claims from insurance carriers, patient account collection including pre-collect and working with outside collection vendors.
ESSENTIAL RESPONSIBILITIES
- Assist incoming calls to the billing department in a prompt and courteous manner; researching account balances for payment resolution.
- Verify patient insurance coverage for your payer.
- Accurately add payer information into patient chart.
- Post all payments by line item in a timely and accurate manner. Balance transactions at the completion of each batch.
- Identify all payments and rejections that weren't processed correctly or according to contract for further department action.
- Accurately and timely, create a secondary claim in NextGen and forward the explanation of benefits to insurance claims processing staff.
- Print and forward all EOB's to appropriate insurance collector identified as not paid per contract or require additional information and research.
- Process refund forms for all accounts identified during posting as overpaid.
- Work with insurance companies to identify payments that were received without explanation of benefits or not identifiable.
- Identify, track, and resolve overdue insurance balances using NextGen tasking system.
- Communicate with payers to appeal payments that do not match contractual agreements.
- Prepare and submit professional appeal letters to insurance payers on claims rejected or paid incorrectly.
- Resubmit insurance claims as necessary with all supporting documentation.
- Respond to written and telephone inquiries from insurance carriers.
- Manage relationships with staff from assigned insurance carriers.
- Process refund request form for all accounts identified as overpaid.
- Provide support on patient account calls in a prompt and courteous manner. Research accounts balances and correct errors as necessary.
- Meet with Manager regularly to discuss reimbursement and insurance follow up problems, patient account status
- Maintain patient confidentiality; comply with HIPAA and compliance guidelines established by the practice.
- Performs other duties or functions as assigned.
REQUIRED/DESIRED QUALIFICATIONS
Education, Training and Experience:
- High school diploma
- Accounts Receivable billing experience in the medical field is required
Specific skills, knowledge and abilities:
- Proven success in receivables follow-up and denials management
- Proven success in payment posting and balancing a cash drawer
- Working knowledge of medical billing and managed care
- Strong verbal communication skills
- Highly organized, detail oriented, and self-motivated
- Microsoft Office and Windows based computer applications
Remote Requirements
- Employee provides clearly defined safe workspace including (but not limited to) desk, chair, surge protector and high speed internet.
- Employee agrees that OAM equipment will not be used by anyone other than the employee and only for business related work. The employee will not make any changes to security or administrative settings on OAM equipment. The employee understands that all tools and resources provided by the company shall remain the property of the company at all times.
- The employee will report any internet or power outages to his or her supervisor and make appropriate temporary work arrangements for completing work duties.
- Employee will review further remote requirements in the Telecommuting Agreement and sign prior to acceptance of employment.
Motor, sensory and physical requirements:
- Ability to sit for prolonged periods of time
- Frequent bending, stooping, lifting and reaching required
- Employee may be required to lift up to 30 pounds.
- Manual dexterity required to operate modern office equipment
- Employee must have normal or correctible range of hearing and eyesight.
Additional Information
- Paid Vacation
- 401(k)
- Profit Sharing
- Health Insurance
- Vision Insurance
- Dental Insurance
- Life Insurance
- Company paid Short and Long Term Disability