Medical Billing Specialist - Commercial Billing

Medical Billing Specialist - Commercial Billing
** Medical Billing Specialist - Commercial Billing
**** Mary Free Bed Summary
** We have the great privilege of helping patients and families re-build their lives. It’s extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients “Ask for Mary,” they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers.

Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary Free Bed Network provides patients throughout the state with access to our unique standard of care
** Mission Statement
** Restoring hope and freedom through rehabilitation.
** Employment Value Proposition
** At Mary Free Bed, we take pride in our values-based culture:
* ** Focus on Patient Care.
** A selfless drive to serve and heal connects all MFB employees.
* ** Clinical Variety and Challenge.
** An inter-disciplinary approach and a top team of professionals create ever-changing opportunities and activities.
* ** Family Culture.
** We offer the stability of a large organization while nurturing the family/team atmosphere of a small organization.
* ** Trust in Each Other.
** Each employee knows that co-workers can be trusted to make the right decision for our family, patients, staff, and community.
* ** A Proud Tradition**. Years of dedicated, quality service to our patients and community have yielded a reputation that fills our employees with pride.
** Summary
* * The Medical Billing Specialist/Denial Prevention Analyst is knowledgeable of payer regulations, as it relates to area of billing responsibility to ensure compliance with billing regulations.  The Medical Billing Specialist/Denial Prevention Analyst will ensure accurate and timely submission and follow up on inpatient and outpatient claims.
** Essential

Job Responsibilities
*** Maintain patient confidentiality as it is described in the HIPAA Privacy Act
* Submit timely, accurate and compliant insurance claims by utilizing the billing software
* Timely follow up with patients and insurance companies on all unpaid claims until resolution; this includes  + Understanding payor denial of claims reasons  + The payor appeals process and sending necessary medical records
* Resolve credit balance accounts; this includes  + Research and understanding of processed claims to determine why there’s a credit balance  + Work with insurance company to process refunds as appropriate
* Reviews explanation of benefits and benefits coverage to determine the best course of action. If needed for further clarification, contact insurance carrier
* Analyzes denial trends for staff/organizational education purposes
* Identify and report any billing system or payer issues to the Patient Financial Services System Analyst or Manager, as appropriate
* Research and identify new or updated billing regulations and notify the Revenue Cycle System Analyst and Manager
* Assist patients with payment options by explaining and offering alternative funding options
* Handle incoming patient calls/e-mails regarding patient accounts
* Assist in identifying additional educational opportunities for training of registration staff with billing regulations/requirements
* Responsible for reviewing clinician notes for appropriate documentation to ensure accurate billing
* Ensure payer and governmental agency regulatory and compliance requirements are consistently followed and applied
* Process insurance rejections, denial, or requests for additional information such as invoices and Medical Records in a timely manner
* Research online medical bulletins and…