Medical Billing Specialist
Wage Range: $21.09 - $33.75 per hour Hybrid in Washington State only
Job Summary: Investigates health plan denials to determine appropriate action and provide resolution.
Primary Duties:
- Investigate insurance denials to identify action necessary.
- Corrects claims based on denials, complaints and audits and rebills using payor approved process.
- Determines need for payor appeal and sends individualized appeal letter. Monitors appeals for resolution.
- Adjusts denials determined to be appropriate using the corresponding adjustment code(s).
- Works the accounts that meet denial management criteria and coordinates resolution with other departments.
- Logs all denials including actions and resolution on Denial spreadsheet.
- Identify denial pattern to identify potential process improvement.
- Produces quarterly denial reports.
License, Certification, Education or Experience:
REQUIRED for the position:
- High School graduate or equivalent.
- 1-year previous experience in professional billing.
- Knowledge and experience in working with health care insurers' and their reimbursement systems, especially Medicare, Medicaid, Workers Compensation, Motor Vehicle and contract payers.
- A good understanding of CPT, Modifiers, HCPC, ICD-10 codes and medical terminologies.
- Demonstrated problem solving ability.
- Ten-key by touch
DESIRED for the position:
- College degree/Vocational training in billing or business
Benefit Information: Choices that care for you and your family
- Medical, vision and dental insurance
- On-demand virtual health care
- Health Savings Account
- Flexible Spending Account
- Life and disability insurance
- Retirement plans (457(b) and 401(a) with employer contribution)
- Tuition assistance for undergraduate and graduate degrees
- Federal Public Service Loan Forgiveness program
- Paid Time Off/Vacation
- Extended Illness Bank/Sick Leave
- Paid holidays
- Voluntary hospital indemnity insurance
- Voluntary identity theft protection
- Voluntary legal insurance
- Pay in lieu of benefits premium program
- Free parking
- Commuter benefits
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