Senior Billing Specialist
5 Days onsite at Sunnyvale, California 94085
Salary up to 100K + Benefits
Summary:
This position performs complete medical billing and reimbursement functions and is responsible for all aspects of the
medical revenue cycle for Remote Patient monitoring, Chronic care management and Medical Nutrition Therapy services.
Minimum Qualifications
● Bachelor's degree in accounting, health care administration, finance, business, or related field, with 8+ years of
experience in an office environment or healthcare-related field
● Knowledge of CPT/ICD-10/HCPCS codes and EHR systems such as EPIC, Kareo, eCW, Office Ally, Practice fusion, Athena, AdvanceMD, etc.
● Proficient in medical terminology and insurance plans
● Experience with process improvement, quality control, data analysis and/or reporting
● Integrity and respect for confidentiality and privacy
● Attention to detail and the ability to work with a variety of databases
● Demonstrates the ability to work independently, is self-motivated, and self-directed with excellent verbal and written communication and documentation skills
● Demonstrates strong organizational and time management skills, enabling effective prioritization of workflow to meet client requirements. Possesses excellent customer service skills to ensure client satisfaction.
● Ability to analyze problems and devise strategic solutions
● Experience with using Google Docs, Sheets, Slides and Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel)
Preferred Qualifications
● Certification in Healthcare Billing and Management
Duties and Responsibilities:
● Confirm patient benefits and insurance eligibility by making calls to the insurance provider
● Follow and adhere to all regulations and guidelines set by Medicare, State programs, and HMO/PPO, etc.
● Engage in end-to-end billing process, including charge entry, claim submission (including 837's and 1500 forms),
payment posting, and accounts receivable management and extract reports from billing software
● Engage in follow-ups with insurance companies and medical groups to address outstanding claims and denials, ensuring the resubmission of claims & appeal for payment
● Develop, implement, and execute departmental procedures and processes
● Collect reimbursements and analyze the revenue data to report trends related to errors & denials
● Use data to identify trends, areas for improvement, and opportunities for revenue growth
● Generate insurance reimbursement reports and analytics on key billing metrics, providing insights into the internal and external stakeholders on financial health of the organization
● Analyze and identify opportunities to optimize revenue capture and reduce revenue leakage
● Ensure compliance with healthcare billing regulations and stay current with changes in billing and coding guidelines to ensure accurate and compliant billing practices
● Conduct detailed data audits and clean-up as scheduled and as needed