Medical Biller
📋 Role Overview & Responsibilities
Aspire365 is seeking a highly motivated and experienced team member to join our billing and verification of benefits team. As a billing Specialist this position will be instrumental in analyzing and following up on billed behavioral health claims to determine the appropriate course of action to resolve claims.
The Billing Specialist will be responsible for submitting claims through our online clearinghouse, following up on claim submission, researching and resolving denials, submitting medical records to insurance companies, managing authorizations, and verifying the eligibility of new patients.
Responsibilities
Follow-up on Commercial, Medicaid and Medicare behavioral health claims by phone calls to the insurance companies, websites, if available, or any other resources.
Verify the status of claims that have been billed to quickly and effectively according to our productivity guidelines.
Update claim statuses and keep detailed records of all claims, incliding the explaination of changes or issues with the claims.
Identify, document, and communicate trends in recurring rejections and denials to Executive Team.
Develop process improvements or system edits to eliminate future denials.
Compile and submit medical records to insurance companies when requested.
Verify the coverage and eligibility of new patients.
Complete authorizations forms, submit for approval, track forms submitted and authorization approvals/denials recieved.
Follow-up with facilities, insurance companies, and credentialing departments in regards to claims or billing inquiries.
Maintain strict confidentiality and abide by all HIPPA rules and regulations.
Requirements
Minimum of 3 years medical / behavioral health billing experiece
Understanding of medical terminology, diagnosis codes, denial codes, ICD 9-10 Codes, and calculating fee schedules.
Strong understanding of UB’s, 1500’s and Remittance Advice (RA’s).
Significant experience to know the appropriate questions to ask when calling Insurance companies, to get the necessary information to move forward in resolving the claim.
Develop a solid understanding of assigned client processes in order to review and analyze claims and account receivable functions.Identify client issues consistently and communicate this to team members and Exacutive Team in a timely manner for quick resolution.
Adhere to all company policies, procedures and guidelines in addition to insurance regulations at the federal and state level.
Compensation
$18 - $22 per hour
Benefits
MedicalVisionDentalPTO
Frequently Asked Questions
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This position is located in Sandy, UT with potential relocation and sponsorship assistance depending on candidate qualifications.
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