Insurance Billing Specialist

   SUMMARY OF RESPONSIBILITIES:

• Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Ensures claim information is complete and accurate.
• Obtain and input new authorizations into Raintree for billing purposes.
• Maintain oversight of current authorizations and initiate requests for additional units as required.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
• Address unpaid or rejected claims with insurance companies, resolving issues and resubmitting as necessary.
• Craft and submit appeal letters to insurance providers for denied claims, gathering all necessary supporting documentation.
• When accounts are past due, collaborate with clients to create payment plans that align with provider policies.
• Manages the posting of insurance and patient payments within the Raintree system.
• Follows HIPAA guidelines in handling patient information.
• Confirm patient benefits and eligibility for coverage.
• Discuss benefits and payment options with clients/families.  
• Able to utilize online resources or traditional coding references to research ICD-10 diagnoses and CPT treatment codes.
• As needed, request waivers for AzEIP and DDD clients.
• Collaborate with RCM and ETS Administrative teams
• Attend all required meetings, bringing necessary data and information.

REQUIRED EDUCATION/EXPERIENCE:

• Medical Billing Certification preferred but not required
• Minimum 3 years of experience in medical billing
• Experience of medical insurance/healthcare billing and collections work in a health system or medical practice
• Thorough knowledge and working experience of CPT and ICD10 codes, HCFA 1500, medical terminology, appeal process, billing and insurance regulations and insurance benefits.
• Ability to effectively deal with customers and secure payment, as well as to be able to discuss the finances of patients.
• Exercises good judgment and discretion.
• Familiarity with HIPAA privacy requirements for patient information. Maintains and protects confidential information.
• Proficient in use of Word, Excel, other Microsoft Office tools and Google Workspace
• Good verbal and written communication skills.
• Good telephone and patient relation skills.
• Detail oriented and ability to prioritize work.

BENEFITS

• PTO
• Medical, Dental and Vision offered.
• Simple IRA with company match up to 3%
• Hybrid - remote/in office schedule
• Life Insurance of $50k per employee (can opt to increase this for a minimal employee cost)
• Long Term Disability 

SALARY

• Hourly - $22-25/hr