Medical Biller Collections Specialist - Remote | WFH - Get It Recruit - Healthcare
Wayne, NJ 07470
About the Job
We are a boutique company specializing in Durable Medical Equipment (DME) and enteral nutrition formulas, including medical foods for inborn errors of metabolism. We are currently seeking a remote, experienced Medical Biller & Collections Specialist with a background in DME and enteral supplies.
Our mission is to assist those facing healthcare reimbursement challenges, particularly individuals dealing with rare diseases and conditions requiring enteral nutrition and medical foods to sustain and prolong their lives.
Position Details:
Employment Type: Contract (1099)
Availability: Full-time and part-time positions
Equal Opportunity: We are committed to non-discrimination in employment on any basis including race, creed, color, age, sex, religion, or national origin.
Essential Qualifications:
Minimum of three years of medical billing experience, including familiarity with HCPCS codes and claims submissions.
Strong background in the DME industry and familiarity with various payers and health plans.
Understanding of HIPAA compliance and adherence to confidentiality rules.
Key Responsibilities:
Navigate interactions between patients, healthcare providers, and insurance companies to secure reimbursement for healthcare services.
Ensure accurate billing and timely submission of electronic and paper claims.
Monitor claim status, research rejections and denials, document account activities, and post adjustments and collections for Medicare, Medicaid Managed Care, and commercial insurance payers.
Apply critical thinking skills and an understanding of Medicare and Medicaid eligibility requirements and commercial insurance payer payment methods.
Demonstrate proficiency with the billing system to maximize efficient claim processing.
Major Duties:
Handle charge and payment entries within Electronic Health Records.
Correct, complete, and process claims for all payer codes.
Analyze and interpret claims to ensure accurate submission to insurance companies.
Follow up with Medicare, Medicaid, Medicaid Managed Care, and commercial insurance companies on unpaid accounts identified through aging reports.
Process appeals online or via paper submission.
Assist in reconciling deposits and patient collections.
Support billing audit processes and information.
Process refund requests.
Participate in weekly meetings to streamline work performance and develop action plans.
Communicate with the billing and credentialing coordinator to resolve audit review issues.
Identify trends and carrier issues related to billing and reimbursements, and report findings to the Team Lead and/or Supervisor.
Conduct research, record findings, and communicate effectively with the Manager to achieve optimal performance.
Engage in ongoing education to stay current with changes in the healthcare industry.
Maintain patient confidentiality and protect medical office operations in compliance with HIPAA.
Contribute to team efforts by achieving related results as needed.
Foster effective working relations and function as part of a team to meet departmental goals and objectives.
Uphold respect and regard for the dignity of all patients, families, and colleagues to ensure a professional, responsible, and courteous environment.
Perform other duties as assigned to support the company's Mission, Vision, and Values.
Qualifications:
High School Diploma required, Associate Degree preferred.
Certified Biller and Coder strongly preferred.
Previous experience with Electronic Medical Records (e.g., eClinical Works, Office Ally, Availity, Navinet) preferred.
Excellent organizational and time management skills.
Strong written and verbal communication skills.
Proficiency in Microsoft Office (Word, Excel, cloud drives).
Ability to work independently and as part of a team.
Customer service-driven mindset with strong compassion for people.
Strong analytical skills and problem-solving abilities.
Work Environment:
Tasks are straightforward, routine, and guided by established policies and procedures.
Limited independent judgment required, with frequent, ongoing supervision.
Routine problem-solving affecting a few individuals, typically within the department.
Information sharing and interactions primarily with customers, supervisors, and coworkers.
Follow established rules and procedures, with decisions having minimal impact on the company.
If you are passionate about helping people and have the qualifications and experience we're looking for, we encourage you to apply for this rewarding opportunity. Join us in making a difference in the lives of those who rely on enteral nutrition and medical foods.
Employment Type: Full-Time
Salary: $ 16.00 21.00 Per Hour
Our mission is to assist those facing healthcare reimbursement challenges, particularly individuals dealing with rare diseases and conditions requiring enteral nutrition and medical foods to sustain and prolong their lives.
Position Details:
Employment Type: Contract (1099)
Availability: Full-time and part-time positions
Equal Opportunity: We are committed to non-discrimination in employment on any basis including race, creed, color, age, sex, religion, or national origin.
Essential Qualifications:
Minimum of three years of medical billing experience, including familiarity with HCPCS codes and claims submissions.
Strong background in the DME industry and familiarity with various payers and health plans.
Understanding of HIPAA compliance and adherence to confidentiality rules.
Key Responsibilities:
Navigate interactions between patients, healthcare providers, and insurance companies to secure reimbursement for healthcare services.
Ensure accurate billing and timely submission of electronic and paper claims.
Monitor claim status, research rejections and denials, document account activities, and post adjustments and collections for Medicare, Medicaid Managed Care, and commercial insurance payers.
Apply critical thinking skills and an understanding of Medicare and Medicaid eligibility requirements and commercial insurance payer payment methods.
Demonstrate proficiency with the billing system to maximize efficient claim processing.
Major Duties:
Handle charge and payment entries within Electronic Health Records.
Correct, complete, and process claims for all payer codes.
Analyze and interpret claims to ensure accurate submission to insurance companies.
Follow up with Medicare, Medicaid, Medicaid Managed Care, and commercial insurance companies on unpaid accounts identified through aging reports.
Process appeals online or via paper submission.
Assist in reconciling deposits and patient collections.
Support billing audit processes and information.
Process refund requests.
Participate in weekly meetings to streamline work performance and develop action plans.
Communicate with the billing and credentialing coordinator to resolve audit review issues.
Identify trends and carrier issues related to billing and reimbursements, and report findings to the Team Lead and/or Supervisor.
Conduct research, record findings, and communicate effectively with the Manager to achieve optimal performance.
Engage in ongoing education to stay current with changes in the healthcare industry.
Maintain patient confidentiality and protect medical office operations in compliance with HIPAA.
Contribute to team efforts by achieving related results as needed.
Foster effective working relations and function as part of a team to meet departmental goals and objectives.
Uphold respect and regard for the dignity of all patients, families, and colleagues to ensure a professional, responsible, and courteous environment.
Perform other duties as assigned to support the company's Mission, Vision, and Values.
Qualifications:
High School Diploma required, Associate Degree preferred.
Certified Biller and Coder strongly preferred.
Previous experience with Electronic Medical Records (e.g., eClinical Works, Office Ally, Availity, Navinet) preferred.
Excellent organizational and time management skills.
Strong written and verbal communication skills.
Proficiency in Microsoft Office (Word, Excel, cloud drives).
Ability to work independently and as part of a team.
Customer service-driven mindset with strong compassion for people.
Strong analytical skills and problem-solving abilities.
Work Environment:
Tasks are straightforward, routine, and guided by established policies and procedures.
Limited independent judgment required, with frequent, ongoing supervision.
Routine problem-solving affecting a few individuals, typically within the department.
Information sharing and interactions primarily with customers, supervisors, and coworkers.
Follow established rules and procedures, with decisions having minimal impact on the company.
If you are passionate about helping people and have the qualifications and experience we're looking for, we encourage you to apply for this rewarding opportunity. Join us in making a difference in the lives of those who rely on enteral nutrition and medical foods.
Employment Type: Full-Time
Salary: $ 16.00 21.00 Per Hour
Source : Get It Recruit - Healthcare