Medical Biller

MEDICAL BILLER AND AR (End to END RCM) - Specialist

• Would you like to join an organization that is experiencing rapid growth You may be the person we are looking for!

NextGen Business Solution looking for experienced end to end RCM specialist

NGBS was founded with the goal of revolutionizing health care by providing exemplary services to our value-based service partners.

Great work comes from people who are inspired to achieve their best. Our team is made up of talented and experienced individuals dedicated to improving healthcare quality. You will find ample opportunity for growth and innovation within NGBS's fast-growing company.

• PRINCIPAL ACCOUNTABILITIES

After patient transactions have been properly coded, create billing batches

• Review information from the patient's file on system chart

Verify insurance coverage

• Bill per procedure and appropriate contract

Verify procedures and check modifiers

• Calculate correct fee and process billing transactions

Experience working in EClinical work software/ Kareo

• The Biller demonstrates general knowledge of billing practices and maintains departmental standards relating to insurance claims processing, charge entry and billing functions

This role is also responsible for providing support to other departments within the NGBS related to billing functions, including communicating claim issues to departmental management for further discussion with payor representatives and other key stakeholders as needed and as applicable

• Provides support for the revenue cycle departments (as applicable: payment posting, coding and accounts receivable (AR) follow up) related to administrative duties as needed

Assists with knowledge sharing, payor and department training, and provides support to other team members as advised by the manager and/or supervisor

• Train new employees in billing, posting and AR

Resolves routine insurance billing inquiries and problems within departmental standards

• Follows established departmental workflows within the electronic health record system appropriate work queues in response to correspondence/reports/data/requests received

Processes financial/insurance correspondence received associated to billing functions

• Meets departmental productivity and quality standards

Completes claim edits timely, compliantly, and without errors

• Documents clear, concise and complete notes in system for each account worked

Identifies claim processing issues and general billing trends

• Notifies supervisor and/or manager regarding trends to avoid further delay in claims processing

Demonstrates understanding of fundamentals of all payers, including Medicare, Medicaid and commercial payers, and applicable revenue cycle operations

• Maintains strict confidentiality of patients, employees and hospital information at all times

Ensures protection of private health and personal information

• Adheres to all Health Insurance Portability and Accountability Act (HIPAA)

Ensures claims are submitted within payor deadlines and reports barriers to claim submission to management

• Completes billing functions within established departmental standards including billing related work queues and workflows to ensure claims are billed accurately, compliantly, and timely

Resolves basic edits, rejections, and unresolved/no response insurance claims

• Processes actions to resolve clearinghouse billing, rejections, and eligibility related errors to ensure timeliness of charge/claim submission

Monitors and processes all no response claims for timely resolution of services within established work queues

• Where applicable, submits accurate adjustments based on billing guidelines and departmental policies, contract requirements, or levels of authority

Remains current on billing guidelines and regulations of various payers and/or specialty practices as directed by the supervisor and/or manager

• MINIMUM QUALIFICATIONS

• Education: Bachelor's Degree

4+ years experience in Billing and Posting

• 1+ years experience working with ECW software

Strong skills in CMS and insurance specific guidelines for billing

Job Types: Full-time, Permanent

Pay: 20,

• 00 - 29,000.00 per month
  
  Benefits:
• Health insurance

Provident Fund
Schedule:

• Day shift

Fixed shift

• Monday to Friday

Morning shift
Supplemental pay types:

• Yearly bonus

Application Question(s):

• How many years of experience do you have in charge entry

How many years of experience do you have in payment posting

• How many years of experience do you have in E-Clinical works software

Experience:

• Medical billing: 1 year (Required)

Work Location: In person