Medical Billing Specialist

Avance Care; United States; Hybrid; USD 52.000 - 75.000; Vollzeit

Benefits dieser Stelle

Healthcare benefits

Hybrid work schedule

Zusammenfassung

Avance Care is seeking a Billing Specialist to secure revenue by ensuring timely payment of claims and resolving rejections across payer partners. The role supports a fast-paced network spanning 37 practice locations in the Triangle, Charlotte, and Wilmington, NC, with a four-day remote and one-day onsite schedule.

You will oversee the claim cycle, address denials, file appeals, and collaborate with the Payments, Coding, and Practice locations to ensure accurate billing and timely reimbursements.

Qualifikationen

• High school diploma or related post-secondary certificate preferred.
• 1–2 years of related billing experience preferred.
• Knowledge of insurance practices preferred.
• Payer policy research and analysis skills preferred.
• Denial analysis and trending skills preferred.
• Knowledge of the HCFA 1500 claim form preferred.

Aufgaben

• Oversee the Claim Cycle to resolution, ensuring efficiency and accuracy.
• Reviews and resolves front end rejections in Clearinghouse and Billing Software.
• Research, address, and resolves all payer claim denials, account discrepancies and payment variances.
• Contacts appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution. Re-file or bill to patient as appropriate.
• Addresses and resolves incoming phone calls from insurance companies regarding claim denials or processing.
• Research and collect information to submit appeals. Follow-up on all billing related appeals.
• Provide Medical Records and supporting documents to various insurance company websites to assist with claim resolutions.
• Process insurance refunds and reconciles patient accounts in billing system.
• Process patient payments over the phone, post payments to appropriate accounts and provides receipts.
• Collaborates with Payments/Collections Team and Outsource Call Center associates regarding patient inquiries.
• Collaborates with Coding Team regarding discrepancies for claim denials.
• Aids Practice locations regarding account, insurance, or billing process inquiries.
• Completes audit for AR work performed by Outsource associates.

Kenntnisse

Communication skills

Insurance knowledge

Payer research

Denial analysis

HCFA 1500 form

Ausbildung

High School Diploma

Jobbeschreibung

Overview

Exciting Career Opportunity with Avance Care!

Join our rapidly expanding network of 37 practice locations in the Triangle Area (Raleigh-Durham-Chapel Hill), the Charlotte Region, and Wilmington, NC.

Avance Care is dedicated to elevating the standard of healthcare. As one of North Carolina's largest networks of independent primary care practices, we offer comprehensive services to support the physical, mental, and emotional health of our patients.

As a Billing Specialist you’ll secure revenue by ensuring timely payment of claims by insurance companies, resolving both initial rejections as well as processing errors by Avance Care payer partners and clearinghouses. You’ll also ensure maximum reimbursement to the organization by timely follow-up on all claims and having the necessary functions to bill, collect, analyze, and adjudicate billing functions for all clinical services.

• This is a full-time role involving 8 hours weekday shifts with no weekends schedule.
• The position works a hybrid schedule with 4 days remote and 1 day onsite.
• We operate in a busy, fast-paced environment, and we seek a candidate who thrives under such conditions.
• We offer a comprehensive benefits package available on the first of the month following 30 days of employment.

Selected Responsibilities:

• Oversee the Claim Cycle to resolution, ensuring efficiency and accuracy
• Reviews and resolves front end rejections in Clearinghouse and Billing Software
• Research, address, and resolves all payer claim denials, account discrepancies and payment variances
• Contacts appropriate party regarding claims denial via outbound calls, insurance portals, fax, or email to ensure final resolution. Re-file or bill to patient as appropriate
• Addresses and resolves incoming phone calls from insurance companies regarding claim denials or processing
• Research and collect information to submit appeals. Follow-up on all billing related appeals
• Provide Medical Records and supporting documents to various insurance company websites to assist with claim resolutions
• Process insurance refunds and reconciles patient accounts in billing system
• Process patient payments over the phone, post payments to appropriate accounts and provides receipts
• Collaborates with Payments/Collections Team and Outsource Call Center associates regarding patient inquiries
• Collaborates with Coding Team regarding discrepancies for claim denials
• Aids Practice locations regarding account, insurance, or billing process inquiries
• Completes audit for AR work performed by Outsource associates

Other Priorities:

• Strong verbal and written communication
• Knowledge of insurance practices
• Payer policy research and analysis skills, preferred
• Denial analysis and trending skills, preferred
• Knowledge of the HCFA 1500 claim form, preferred

Candidates should have a High School Diploma, or post-secondary certificates in related field, preferred. Along with 1-2 years related billing experience preferred.

Avance Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, gender identification, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state or local law.