Medical Billing & Collections Specialist; Audit

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Summary

We are seeking a dedicated Medical Billing & Collections Audit Specialist to join our Billing Center Division. This position is responsible for reviewing and responding to all Prepay and Post-Pay audits within the required time frame.

Pay starting at $15.50

• Mon – Fri scheduled shift / flex hours between 7am – 5pm

Essential Job Duties and Responsibilities

(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities. Duties, responsibilities and activities may change at any time with or without notice.)

• Review all manual re-billing audits for accuracy and route to supervisor for approval before posting, ensuring release of claim
• Contact physicians, facilities, patients, or locations to gather documentation needed to respond to an audit
• Document all work in NAT notes in eIntake
• Maintain good communication with locations and auditors
• Process all payer appeal requests within the time frame required by the payer
• Process all adjustments within iWorkQ
• Report to BCC Supervisor any trends that will prevent future audits
• Resolve emails from BCC Supervisor/BCM and locations within 48 hours
• Review all post-pay and prepay audits for appropriate action and respond within the required time frame
• Review patient information in IMBS to determine if an adjustment is valid
• Review the EMR to gather all documentation for an audit
• Performs other duties as assigned

Qualifications

Employment is contingent on

• Background check (company-wide). Results will be considered with individualized assessment in accordance with applicable laws
• Drug screen (when applicable for the position)
• Compliance with healthcare facility credentialing process (when applicable for the position)
• Valid driver’s license in state of residence with a clean driving record (when applicable for the position)

Required Education and/or Experience

• High school diploma or GED equivalent, required

Preferred Education and/or Experience

• Experience with medical billing practices and billing reimbursement
• Experience in medical field and administrative record management
• One year of related work experience
• Medical terminology

Skills and Competencies

• Accurately perform simple mathematical calculations
• Effectively communicate in English; both oral and written
• Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
• Maintain confidentiality and discretion when handling sensitive information
• Multi-task with attention to detail
• Self-motivation, organized, time-management and deductive problem solving skills
• Work independently and as part of a team

Machines, Equipment and Technical Abilities

• Email transmission and communication
• Internet navigation and research
• Microsoft applications (Outlook, Word, Excel)
• Office equipment (fax, copier, printer, phone, computer/tablet)

Physical Demands

• Lift and carry office equipment as needed
• Sitting, walking, standing, talking and listening
• Close vision to small print on computer, tablet and paperwork

• Generous paid time off and paid holidays
• Overtime pay for non-exempt positions (as applicable)
• Commission for Account Executives
• Bonus and incentive opportunities
• Fixed and variable car reimbursement for Area Managers and Account Executives
• Car, mileage, and telephone reimbursement (as applicable)
• Em…