Texas Regional Physicians
Overview
Medical Billing Specialist at Texas Regional Physicians. The Medical Billing Specialist is responsible for the billing, collections, follow up and appeals of insurance claims and patient accounts. Essential to this position is the ability to manage all insurance follow up for maximum insurance reimbursement. This includes outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials and resolving unpaid claims. Responsibilities
Claim submission Work assigned claim volume timely and efficiently within corporate timeframes Actively follow-up on outstanding patient account balances, and all insurance claims using A/R aged reports, including resolution of any billing errors Research, appeal, and resolve unpaid insurance claims Respond to correspondence from insurance carriers Collect and post payments in patient accounts Contact customers regarding outstanding balances Resolve partial payments or denials from insurance companies Insurance verification Review explanation of benefits and correspondence Follow up on returned claims, correspondence denials, account reconciliations and rebills Monitor and reconcile reimbursement from managed care networks and insurance carriers ensuring correct reimbursement with contracted rates Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursements to providers, managers, and staff Performs other job-related duties as assigned Follow all processes and procedures as set by leadership Stay informed of changes with procedures, billing guidelines, and laws for specific insurance carriers or payers Demonstrates ability to communicate clearly with insurance company representatives regarding claim follow-up and appeals Maintain proficiency with computer and Windows applications (e.g., Excel and Word) and willingness to learn new systems Qualifications
Athena experience is a plus Minimum 5+ years of experience with insurance follow up and insurance collections Minimum 3+ years of experience with Ambulatory Surgery Center verification of benefits, billing, and/or collections Knowledge of both in-network and out-of-network facility and physician claims Strong oral and written communication skills Positive attitude, team player and ability to work independently Experience in reading, analyzing and interpreting EOBs Prior experience with commercial payers such as UHC, Cigna, Aetna, BCBS, Work Comp and Third Party is a plus Proven experience administering appeals in a high-volume claims environment Proven experience in a production-based environment with focus on meeting production standards Ability to clearly communicate claim follow-up and appeals with insurance company representatives Excellent problem-solving and negotiating skills Familiarity with computer and Windows PC applications with the ability to learn new systems Benefits
401(k) 401(k) matching Dental insurance Disability insurance Health insurance Life insurance Paid time off Vision insurance Schedule: Monday to Friday Work Location: one to two locations Texas Regional Physicians does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, national origin, marital status, citizenship status, physical or mental disability or veteran status.
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Medical Billing Specialist at Texas Regional Physicians. The Medical Billing Specialist is responsible for the billing, collections, follow up and appeals of insurance claims and patient accounts. Essential to this position is the ability to manage all insurance follow up for maximum insurance reimbursement. This includes outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials and resolving unpaid claims. Responsibilities
Claim submission Work assigned claim volume timely and efficiently within corporate timeframes Actively follow-up on outstanding patient account balances, and all insurance claims using A/R aged reports, including resolution of any billing errors Research, appeal, and resolve unpaid insurance claims Respond to correspondence from insurance carriers Collect and post payments in patient accounts Contact customers regarding outstanding balances Resolve partial payments or denials from insurance companies Insurance verification Review explanation of benefits and correspondence Follow up on returned claims, correspondence denials, account reconciliations and rebills Monitor and reconcile reimbursement from managed care networks and insurance carriers ensuring correct reimbursement with contracted rates Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursements to providers, managers, and staff Performs other job-related duties as assigned Follow all processes and procedures as set by leadership Stay informed of changes with procedures, billing guidelines, and laws for specific insurance carriers or payers Demonstrates ability to communicate clearly with insurance company representatives regarding claim follow-up and appeals Maintain proficiency with computer and Windows applications (e.g., Excel and Word) and willingness to learn new systems Qualifications
Athena experience is a plus Minimum 5+ years of experience with insurance follow up and insurance collections Minimum 3+ years of experience with Ambulatory Surgery Center verification of benefits, billing, and/or collections Knowledge of both in-network and out-of-network facility and physician claims Strong oral and written communication skills Positive attitude, team player and ability to work independently Experience in reading, analyzing and interpreting EOBs Prior experience with commercial payers such as UHC, Cigna, Aetna, BCBS, Work Comp and Third Party is a plus Proven experience administering appeals in a high-volume claims environment Proven experience in a production-based environment with focus on meeting production standards Ability to clearly communicate claim follow-up and appeals with insurance company representatives Excellent problem-solving and negotiating skills Familiarity with computer and Windows PC applications with the ability to learn new systems Benefits
401(k) 401(k) matching Dental insurance Disability insurance Health insurance Life insurance Paid time off Vision insurance Schedule: Monday to Friday Work Location: one to two locations Texas Regional Physicians does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, national origin, marital status, citizenship status, physical or mental disability or veteran status.
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