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Medical Billing Specialist - Massapequa, NY

Medical Billing Specialist - Massapequa, NY

ConvaTecLong Key, FL, US
4 days ago
Job type
  • Full-time
Job description

Billing & Invoicing Specialist

Billing & Invoicing work is focused on designing and ensuring compliance with billing and invoicing processes including :

  • Information verification (e.g., ensure accuracy of billing information, negotiated terms and compliance with current legislation)
  • Monitoring customer accounts (e.g., ensure payments made on time, report on overdue accounts, etc.)
  • Resolving billing discrepancies (e.g., investigate and resolve billing & invoicing errors, recommend process improvements to avoid future errors, etc.)
  • May include collections activities

Requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. May require the following proficiency :

  • Works under moderate supervision.
  • Problems are typically of a routine nature but may at times require interpretation or deviation from standard procedures.
  • Communicates information that requires some explanation or interpretation.
  • Key Responsibilities :

  • Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior to submission.
  • Follows up with insurance companies on unpaid or rejected claims. Resolves issues and resubmits claims.
  • Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations.
  • Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer issues in an effort to recover proper reimbursement.
  • Provides customer service relating to all billing inquiries and complaints. Able to explain insurance processes, benefits, and exclusions. Follows HIPAA guidelines in handling customer information.
  • Performs other billing duties as requested by the Billing Supervisor, Billing Manager, or Director of Billing.
  • Qualifications / Education :

  • Must have a high school diploma, college degree preferred, not required.
  • Six months to one year of related experience and / or training; or equivalent combination of education and experience.
  • Proficient in use of computers and software including, but not limited to : practice management software, word processing and spreadsheet applications.
  • Detail oriented with ability to multi-task.
  • Manages one's own time with minimal supervision.
  • Strong mathematics and problem-solving skills.
  • Seeks and shares pertinent information related to insurance or internal processes.
  • Communicates effectively both verbally and in writing to convey and receive information.
  • Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Self-evaluates performance to make improvements or take corrective action. Consider the relative costs and benefits of potential actions to choose the most appropriate one.
  • Use equipment, facilities, and materials appropriately as needed to do certain work.
  • This position must commit to 9 months in the role before applying for alternative roles within the organization. Exceptions must be approved by Department leadership.
  • Physical Demands :

  • Regularly required to sit, stand, walk, and occasionally bend and move about the facility.
  • Infrequent light physical effort required.
  • Occasional lifting under 10 lbs.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Working Conditions :

  • Work performed in an office environment.
  • Special Factors :

  • This role can be performed remotely.
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    Medical Billing Specialist • Long Key, FL, US

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