Join Our Team

Responsibilities:

• Improve the medical billing cashflow by

o Handling and resolving escalated denials for Commercial insurance, Medicare, and Workers Comp that require special attention

o Contacting insurance carriers, attorneys, and adjusters to resolve reimbursement issues.

o Prepare guidelines and train other AR executives on how to handle unpaid medical claims and denials

o Work closely with AR Manager and RCM Manager to discuss and address reimbursement trends and issues.

• Handle escalated and complex AR denials by:

o Reviewing and interpreting the  insurance explanation of benefits.

o Working denials received from insurance companies.

o Respond to inquiries from insurance companies, patients, and providers.

o Appropriately documenting all communications with insurance carriers, attorneys, and adjusters.

o Resubmitting claims, file appeals, update status, complete all steps to resolve denials, and complete associated paperwork. 

o Foster relationships and keep steady communication with insurance carriers.

• Enhance Customer Satisfaction by:

o Analyzing and summarizing the Ageing and billing information

o Update them on the status of the specific claims and collection trends

o Make recommendations and create action plans that will improve the payments and reduce denials.

Qualifications:

• Minimum 2-3 years’ experience as a medical Accounts Receivables and Medical billing.

• Full understanding of medical insurance and claim processing terminology.

• Experience in CPT and ICD-10 coding; familiarity with medical terminology, bundling and reimbursements.

• Outstanding phone and written communication skills

• Excellent computer skills (Excel, word, and emails)

• Ability to multitask, must be organized, detail-oriented, self-motivated and focused.

• Experience working with Workers Compensation and Commercial Insurance carriers, is highly desirable.