XRHealth Medical Billing Specialist in Brookline, Massachusetts
Principle Duties and Responsibilities:
Be the main point of contact for our third-party billing company.
Manage self-pay patients including collecting charges and issuing refunds when applicable.
Responsible for obtaining and maintaining prior authorizations per patient’s insurance plan requirements
Collect, verify, and document all patient’s information, including insurance and eligibility information to manage their medical records in the EHR
Manage the clinic schedule including follow up on cancellation and no-show
Submit accurate/clean claims to insurance carriers for payment, including coordinating benefits with multiple insurance carriers.
Review claim payments for proper reimbursements; appealing underpaid or denied claims as needed.
Telephone, mail, and email communication with insurance companies regarding open or denied claims.
Review patient insurance, billing & collections, and data processing to ensure accurate patient billing and efficient account collection.
Review the coding work queues accessing the accuracy of CPT and ICD-10 coding to ensure compliance, correcting issues & releasing bills for processing.
Establish and implement billing policies and procedures, as well as research, recommend and implement best business practices.
Maintain up-to-date expertise and knowledge of healthcare billing laws, rules, regulations and developments to inform business decisions and assure compliance with applicable rules & regulations.
Act as a liaison between the billing staff and Clinicians / Providers regarding billing issues and education.
Bachelor’s Degree Preferred
Excellent customer service and communication skills
2-3 years of experience medical billing experience needed; experience in an outpatient clinic strongly desired, rehabilitation and telehealth is a plus.
Knowledge with CPT & ICD-10 coding requirements.
Extensive knowledge of relevant billing regulations and insurance regulations, reimbursement systems.
Ability to prioritize and manage multiple responsibilities, manage projects, demonstrate leadership and cultivate strong working relationships with Senior Management and others throughout the organization.
Ability to review clinician documentation & assist them to meet requirements
Working knowledge of Kareo (HER/Billing) a plus, EHR/EMR experience required
Powered by JazzHR