Healthcare Billing and Management Association

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Medical Billing & Charge Review Specialist - CA

Quick Facts
Company Name:pMD
Location:CA
Employment Type:Part Time
Category:Other
Pay:$27.54 per hour
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Description

(Part-time) Medical Billing & Charge Review Specialist

The (Part-time) Medical Billing & Collections Specialist role at pMD helps our team and our customers reach our business goals through expeditious claim submission and thoroughly scrubbing claims for coding and billing accuracy. This is an important role that primarily focuses on the front-end revenue cycle. This includes identifying and preventing all claim errors that would result in a denial to support timely payment and exceed industry standard benchmarks.

Responsibilities include:

    • enter patient registration data within a software solution
    • perform insurance verification and identify correct coverage and coordination of benefits
    • identify cost sharing, patient out of pocket expenses post insurance adjudication, and initiate patient payment requests
    • perform claim scrubbing review to support coding and billing accuracy and clean claim submission
    • transmit and process all billable claims and ensure claims are billed expeditiously
    • monitor claims for reconciliation and interface rejections
    • proactively communicate coding errors identified to manager for future prevention

Requirements include:

    • post-secondary certificate in Medical Billing and Coding
    • 2 years of medical billing experience with an emphasis on claim scrubbing and coding
    • must be proficient with CPT/ICD-10, NCCI edits, and abreast of the latest coding guidelines issued by the AMA and CMS
    • proficient in health insurance eligibility
    • availability to start immediately and work 25 hours per week between the operating hours of 8 am EST and 6 pm EST
    • EMR experience
    • must currently have or be willing to set up a business name per independent contractor guidelines
    • reside in the U.S.
Hourly rate: $27.54 / hour

Candidates must be authorized to work in the U.S. as a precondition of employment.


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