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Medical Billing Specialist (AR and Collections) at Sourcefit

100% Remote Full-time Open now

This a Full Remote job, the offer is available from: Philippines, Arkansas (USA) Position Summary: We are actively seeking an experienced and highly motivated Medical Billing Specialist (AR and Collections) to join our dynamic team. The successful candidate will play a crucial role in managing our collection processes for TDD services. The tasks include contract analysis, reimbursement, denial management, appeals, and resolving billing-related issues with insurance companies or other responsible parties for services rendered. The ideal candidate should possess in-depth knowledge of billing and collection practices and have a strong track record in resolving complex financial situations. Job Details:

  • Medical Billing Specialist (AR and Collections)
  • Permanent work from home
  • Monday to Friday | 8 AM to 5 PM CST I 10 PM to 7 AM (Manila Time)

Responsibilities:

  • Recognize and support patients’ rights and responsibilities in the performance of job duties, while respecting their privacy and confidentiality.
  • Follow up on submitted invoices to ensure prompt and timely payment, escalating issues as necessary.
  • Evaluate payments/denials received for correctness and ensure they are applied accordingly.
  • Identify bad debt write-offs and A/R adjustments. Initiate write-offs and adjustments in accordance with established policies and procedures.
  • Detect any overpayments and/or duplicate payments and investigate and resolve accordingly.
  • Process refund requests, in accordance with policies and procedures.
  • Maintain contact with other departments to obtain the patient or insurance information needed for claim payment.
  • Understand all procedures within regulatory mandates.
  • Ensure that the collection operations are conducted in a manner that is consistent with overall department protocol and follows Federal, State, and payer regulations, guidelines, and requirements.
  • Make calls to troubleshoot payment discrepancies and establish resolution.
  • Document, in detail, phone calls, phone numbers, persons spoken to, and call details on a consistent basis.
  • Consistently look for areas to maximize claim reimbursement.
  • Resolve issues that caused a denial within 5 days of receipt of denial.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Understand NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
  • Maintain a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
  • Share knowledge gained with other staff members and work as a team member.
  • Interact with others in a positive, respectful, and considerate manner.
  • Perform other job-related duties as assigned.

Qualifications:

  • A high school diploma or general education degree (GED) equivalent.
  • At least 3 years of medical billing and collections experience.
  • Home Infusion experience, hospital, or chemotherapy experience is a plus.
  • Experience in calculating drug units and intrathecal Pain Management is a plus.
  • Ability to recognize, evaluate, and exercise good judgment in solving complex situations and advising by laws and regulations.
  • Excellent verbal and written communication and relationship-building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
  • Strong work ethic with personal qualities of integrity and credibility.
  • Self-directed, detail-oriented, conscientious, organized, and able to follow through.
  • Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
  • Tolerance of frequent interruptions and distractions from staff and other internal support teams.
  • Proficiency in Microsoft Office, including Outlook, Word, and Excel.

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