Mako Medical
Accounts Receivable Billing Representative (Synergy)
Mako Medical, Raleigh, North Carolina, United States, 27601
Overview
Accounts Receivable Billing Representative (Synergy) – Full-time position. The role focuses on processing and following up on claims to maximize payments and patient satisfaction. Requires professional billing experience in healthcare. Essential Job Responsibilities
Work aged receivables utilizing A/R reports assigned by manager Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct, and resubmit or reprocess unpaid claims as necessary Verify validity of account balance by researching, reviewing and ensuring accuracy of payment and adjustment posting Identify liability and guarantor hierarchy and transfer balances timely and appropriately Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes Research and resolve denials and underpayments with insurance carriers Verify all identified insurance carriers for eligibility and confirm carrier policy for referral and authorization requirements as needed for claims adjudication Submit carrier appeals and reconsideration requests in a timely manner Meet productivity goals/benchmarks as set and communicated by Team Lead Maintain confidentiality of patient information Work collaboratively with other Coding, Billing, Patient Success, and Payment Posting Specialists as needed Education
High school diploma or GED Bachelor’s degree preferred Experience
Minimum of 3 years' billing experience in the healthcare industry Prior medical billing experience Knowledge of ICD-10, CPT, HCPCS coding and medical terminology required Problem-solver/ Critical thinking skills/ Self-motivated Ability to organize, prioritize and manage various work assignments in a timely fashion Word and Excel experience preferred Ability to remain professional and courteous with providers and insurance carriers always Experience with Availity and/or Telcor is preferred Quality Standards
Team player who will lead by example and promote a positive work culture when partnering with internal/external business partners Demonstrates initiative, personal awareness, professionalism, and integrity, and exercises confidentiality in all areas of performance Follows all local, state, and federal laws concerning employment including but not limited to I-9, Harassment, EEOC, Civil rights, and ADA Follows OSHA regulations and site protocols, policies, and procedures Follows HIPAA, compliance, privacy, safety, and confidentiality standards at all times Practices universal safety precautions Promotes good public relations on the phone and in person Adapts and is willing to learn new tasks, methods, and systems Reports to work regularly as scheduled; consistently punctual with respect to working hours, meal and rest breaks, and maintains satisfactory personal attendance in accordance with guidelines Consistently adheres to time management policies and procedures Completes job responsibilities in a quality and timely manner Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries Hospitals and Health Care
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Accounts Receivable Billing Representative (Synergy) – Full-time position. The role focuses on processing and following up on claims to maximize payments and patient satisfaction. Requires professional billing experience in healthcare. Essential Job Responsibilities
Work aged receivables utilizing A/R reports assigned by manager Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct, and resubmit or reprocess unpaid claims as necessary Verify validity of account balance by researching, reviewing and ensuring accuracy of payment and adjustment posting Identify liability and guarantor hierarchy and transfer balances timely and appropriately Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes Research and resolve denials and underpayments with insurance carriers Verify all identified insurance carriers for eligibility and confirm carrier policy for referral and authorization requirements as needed for claims adjudication Submit carrier appeals and reconsideration requests in a timely manner Meet productivity goals/benchmarks as set and communicated by Team Lead Maintain confidentiality of patient information Work collaboratively with other Coding, Billing, Patient Success, and Payment Posting Specialists as needed Education
High school diploma or GED Bachelor’s degree preferred Experience
Minimum of 3 years' billing experience in the healthcare industry Prior medical billing experience Knowledge of ICD-10, CPT, HCPCS coding and medical terminology required Problem-solver/ Critical thinking skills/ Self-motivated Ability to organize, prioritize and manage various work assignments in a timely fashion Word and Excel experience preferred Ability to remain professional and courteous with providers and insurance carriers always Experience with Availity and/or Telcor is preferred Quality Standards
Team player who will lead by example and promote a positive work culture when partnering with internal/external business partners Demonstrates initiative, personal awareness, professionalism, and integrity, and exercises confidentiality in all areas of performance Follows all local, state, and federal laws concerning employment including but not limited to I-9, Harassment, EEOC, Civil rights, and ADA Follows OSHA regulations and site protocols, policies, and procedures Follows HIPAA, compliance, privacy, safety, and confidentiality standards at all times Practices universal safety precautions Promotes good public relations on the phone and in person Adapts and is willing to learn new tasks, methods, and systems Reports to work regularly as scheduled; consistently punctual with respect to working hours, meal and rest breaks, and maintains satisfactory personal attendance in accordance with guidelines Consistently adheres to time management policies and procedures Completes job responsibilities in a quality and timely manner Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries Hospitals and Health Care
#J-18808-Ljbffr