Medicare/Medicaid Billing & Claims Specialist

Santa Fe Care; Santa Fe (NM); On-site; USD 36,000 - 60,000; Full time

Job summary

Santa Fe Care is seeking an Assistant Business Office Manager to prioritize and batch material for data entry, post claims in the Practice Management System, and assist with billing and statement processing. This role demands accuracy and efficiency in high-volume environments.

Responsibilities include processing insurance claims, resolving denials, posting payments, assisting with Sliding Fee Scale applications, and supporting audits and policy updates; candidates should have Medical

Qualifications

• Experience in coding and charge entry.
• Knowledge of medical terminology.
• Ability to perform high-volume data entry.
• Proficiency with computer systems.
• English reading and writing fluency.

Responsibilities

• Process insurance claims for various insurances and self-pay patients.
• Research and communicate with insurances and third parties regarding claim denials.
• Make billing/coding corrections and refile denied claims for reprocessing.
• Help processing and posting patient payments.
• Prepare and mail weekly patient statements.
• Answer patient inquiries regarding account status.
• Identify, research and resolve patient billing issues.
• Contact patients regarding collections of past due balances.
• Work with patients to establish self-pay arrangements and payment plans.
• Assist with Sliding Fee Scale applications and audit processes.
• Assist with reports to maintain federal funding as requested.
• Assist with updating policies, procedures, and forms.

Skills

Medical terminology

Coding and charge entry

Computer knowledge

English proficiency (read, write, and

Tools

Practice Management System

Job description

Santa Fe Care is seeking an Assistant Business Office Manager to prioritize and batch material for data entry, post claims in the Practice Management System, and assist with billing and statement processing. This role demands accuracy and efficiency in high-volume environments.

Responsibilities include processing insurance claims, resolving denials, posting payments, assisting with Sliding Fee Scale applications, and supporting audits and policy updates; candidates should have Medical