Essential Duties and Responsibilities.
- Maintain AdvancedMD billing platform and perform administrative tasks.
- Full Revenue Cycle process
- Ensures receipt and validity of all documents needed in order to prepare and submit all billing and claims accurately.
- Coordinates with client to obtain appropriate documentation as needed for billing.
- Provides all necessary documentation required to expedite payments. This includes, but not limited to, demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
- Maintains and updates the charge masters for each client.
- Completes and submits all necessary insurance forms and electronic claims to process them in Accordance to the timely filing requirements set by all third-party payors. Communicates with management on a monthly basis regarding any claim issues.
- Independently analyzes, reports, and communicates any reimbursement or billing trends/delays (e.g. payer specific requirements, billing denials, claim denials, pricing errors, payments, etc) to management.
- Ability to perform root cause analysis for the client to ensure proper billing practices and timely payment of claim
- Independently and effectively resolves billing issues with minimal supervision.
- Good judgment in selecting methods and techniques for obtaining solutions.
- Communicates effectively to payers and/or claims clearinghouse to ensure accurate and timely electronically filed claims.
- Researches and resolves any electronic claim denials or rejections through the billing clearinghouse.
- Ability to view pay plans and interpret the information. Ability to verbalize knowledge and understanding of insurance coverage dependent on payer assignment i.e. major medical, PBM, Medicare and Medicaid.
- Ability to understand prior authorization numbers, date spans, and HCPC unit calculations.
- Ability to read and interpret payer contracts and apply them to the billing process.
- Ability to demonstrate clear understanding of CPT and ICD-10 coding. Also, demonstrate a clear understanding of CMS 1500 claim formatting and billing process.
- Provides exceptional customer service to patients and clients (internal and external customers); resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Maintains frequent phone contact with provider representatives, third party customer service representatives, and case managers as needed.
- Maintains work operations by following established policies and procedures. Reports any compliance issues immediately.
Benefits: 401k and Paid Time Off(PTO) ONLY!
Andres Medical Billing (AMB) has been providing EMS billing services since 1995. We are a rapidly growing company that services over 200 clients including fire departments, municipalities, townships and private ambulance services. Our clients are spread out nationally.
Role: Medical Biller and Coding/Full Revenue Cycle
Location: Arlington Heights,
Apply for this job now.