Medical Billing Team Leader

Details of the offer

Duties & Responsibilities

Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers
Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims
Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
Research EOBs for payments or adjustments to resolve claim
Contacts payers via phone or written correspondence to secure payment of claims Access client systems for payment, patient, claim and data info
Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
Secure needed medical documentation required or requested by third party insurance carriers.
Maintain confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
Perform other related duties as required
Utilize provider billing manuals to obtain billing guidelines and requirements.
Write appeal letters for technical appeals
Verifies accuracy of underpayments utilizing contracts and claims data.
Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials
Utilizes reports for analysis and to monitor follow up activities and prioritization
Assists organization with working through special projects as needed
SME for colleagues and provide direction for resolution of accounts
Assists in new hire training
Assists in content building of training materials

Qualifications & Competencies:

3+ years of medical collections/billing experience
2+ years of experience as a Team Leader
Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
Expert knowledge of third-party billing guidelines
Expert knowledge of billing claim forms (UB04/1500)
Expert knowledge of payor contracts
Working Knowledge of Microsoft Word and Excel
Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Must be willing to work onsite.

Preferred Qualifications:

Working knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
Prior team lead experience
Working knowledge of DDE Medicare claim system
Knowledge of government rules and regulations


Nominal Salary: To be agreed

Source: Whatjobs_Ppc

Job Function:

Requirements

Contact Center Solutions Manager - Makati

TASQ Staffing Solutions is looking for a Contact Center Solutions Manager to work in Makati. About the job Urgent | Contact Center Solutions Manager | Makat...


Tasq Staffing Solutions - National Capital Region

Published 19 days ago

Operations Coach/ Team Lead /Supervisor - Us Pioneer Team

Grab the opportunity, achieve your highest potential with iOPEX Technologies! We are looking for awesome and talented leaders for our growing #happy@work te...


Iopex Technologies Philippines - Taguig - National Capital Region

Published 19 days ago

Hr Staff

DIRECT HIRING! HR STAFF _Responsibilities:_ · Provide general clerical and administrative support relating to personnel functions in the areas of recruitmen...


Dempsey Resource Management Inc. - National Capital Region

Published 19 days ago

Program Management Officer (Pmo) Analyst

Must Have: Holder of a Bachelor's Degree in Business Administration or equivalent.Minimum of 3 years of experience as PMO Analyst.Knowledge of project manage...


Hunter'S Hub, Inc. - National Capital Region

Published 19 days ago

Built at: 2024-11-24T08:54:32.102Z