About Us:
Remote Team Solutions focuses on creating great teams for great companies, helping businesses save over 60% on employee salary and benefit costs while eliminating the time and resource burden of active employee management and reducing staff turnover rates.
Our Client:
Provides high-quality intraoperative neurophysiological monitoring (IONM).
Responsibilities: Follow the Billing SOP Manual: Adhere to protocols and guidelines for each payer and follow verbal instructions from the Billing Operations Director.Investigate why payer claims are not on file, why claims were not processed electronically, and ensure no duplicate claims are sent.Review all assigned cases until closure as per the Billing SOP.Update the Insurance Billing SOP with the most recent information and processes for assigned carriers.Call and speak with insurance companies after reviewing the EOB or claim notes to ensure prompt payment of assigned claims.Review EOBs for assigned claims to determine if an appeal, reconsideration, or correction is necessary, verifying that the modifier, CPT codes, and ICD-9/ICD-10 codes are in the correct order.Ensure medical records match the claim form before sending records to insurance companies.Create appeal letters and gather supporting documentation to investigate if appeals are completely denied or if only one item is denied.Proactively search for all possible reasons why a claim may be considered incomplete and work to resolve it.Document all steps performed on each account immediately in the billing software as per the Billing SOP, including documenting that medical records were sent and received by fax or certified mail with acknowledgment of receipt.Verify and appeal, if necessary, all assigned claims that have not been paid according to the calculations of Senate Bill 418.Update the insurance payers' CRM database, including contact information, payer preferences, and any other information that may assist in future collection processes.Adhere directly to all communication guidelines as per specific requests from the insurance payer.Work with the Patient Care Advocate to enlist patient assistance with the claim.Communicate with patients and payers with the utmost respect and professionalism.Investigate insurance fraud and report it to the Billing Director and then to the company's board member as needed.Perform other tasks as assigned. Requirements: 2 or more years of experience in Accounts Receivable in Hospitals, Insurance Companies, or Medical Billing:Experience in managing accounts receivable, accounting, or billing in the medical field.Knowledge in the administration and follow-up of collections from clients, insurers, and medical entities.Ability to resolve invoice discrepancies and coordinate with other areas to solve financial problems.Bachelor's degree in Accounting, Finance, or related field.Conversational English (indispensable).Good Excel skills.Excellent organizational skills and attention to detail.Strong verbal communication skills and confidence in asking questions.Excellent customer service skills:Experience in providing high-quality customer service.Ability to handle inquiries and complaints professionally and efficiently, ensuring customer satisfaction.Excellent written and communication skills. What We Offer: Monday to Friday from 8:00 am to 5:00 pm.American Holidays.Legal benefits.
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