Medical Wound Care AR Specialist - Innovative Company

WHO ARE WE?

PriMed Processing LLC is a comprehensive medical reimbursement service specializing and catering specifically to the needs of neurology practices and neurodiagnostic testing facilities. Since our establishment in 2001 as a woman-owned and operated business, PriMed has developed and implemented processes to present a unique, boutique-style approach to medical billing, which has resulted in the highest collection rates in the industry (95+%). We partner with our clients as an extension of their practice to help protect the financial health of our providers, so they can focus on the health and wellness of their patients. Our incredible and caring team, where the average tenure is over 7 years, serves as advocates and liaisons between the provider, the patient, and the insurance carriers.

WHO ARE YOU?

This job is perfect for the person who hates being bored and relishes taking the necessary, proactive steps to get to the bottom of claims issues; loves details and is not afraid to dig deep into documentation; enjoys investigating and problem solving; believes in holding insurance carriers accountable; and appreciates getting the language right to create a collective understanding. If you are this person, you are a person who genuinely cares and has great empathy for both the patient and the provider. You enjoy collaborating with others and synthesizing information quickly, so it can be communicated with ease. You welcome the challenge of advocating on behalf of the patient and provider to best ensure proper compensation for the care needed. Most importantly, you are going to love being part of the Team at PriMed because you delight and take pride in your work–it is not seen as “just another job,” but work that really matters.

WHAT YOU WILL DO… (RESPONSIBILITIES)

• Scrub/review charges submitted by provider
• Research for proper coding
• Assure electronic claims are submitted on a daily basis
• Review clearinghouse reports to ensure claims are processing through properly
• Resolve claim rejections and improper exclusions
• Research claim denials, fix and correct for refiling
• Exhaustively use all available resources (including, but not limited to, phone calls, chat sessions, and web portals) to thoroughly research, manage and followup on accounts receivables
• Reach out to providers, as necessary, for required supporting documentation
• Identify root cause of issues and work with management to establish protocls to streamline future procedures
• Cross-train for verification of benefits, eligibility, and authorizations
• Communicate clearly and answer billing related questions from insurance companies, clients, and patients
• Set up patient payment plans, as necessary

WHAT YOU NEED… (REQUIREMENTS)

• High school diploma or equivalent
• Minimum of 5 years in the medical billing field
• Solid understanding of health insurance networks, with the ability to differentiate in-network and out-of-network benefits
• Thorough understanding of guidelines and procedures for medical billing (comprehensive knowledge of CPT, HCPCS, and ICD10), collections, and appeals
• Strong organization skills and attention to detail
• Ability to dig deep and problem solve
• Ability to thrive in a fast-paced environment
• Ability to stay focused but also multitask
• Ability to work independently - take ownership and responsibility for one’s own work without constant supervision
• Ability to work as a team - collectively and cooperatively with management, co-workers, customers and carriers
• Clear written and verbal communication skills - must be able to communicate effectively with clients, patients, and payers in a professional and friendly manner
• Self-awareness that enables you to maintain composure, while showing continual empathy, concern, and courtesy to every caller regardless of frustration level

IT WOULD BE GREAT IF… (PREFERENCES)

• Experience with billing Wound Care
• Experience with AdvancedMD EHR and billing software
• Experience with Microsoft Excel, Microsoft Word, Google Docs, and Google Sheets

WHAT WE OFFER… (BENEFITS)

• Family atmosphere
• Independent, yet collaborative, work environment
• Casual dress code
• Great schedule with some flexibility
• Hybrid schedule (work from home 2 days/week)
• Short hours on Friday
• Accrued Paid Time Off (can be used for sick or vacation time)

And all the usual, such as,

• Health insurance
• Life insurance
• 7 paid holidays (regardless of whether the holiday falls on a regular work day or not)
• 401K with up to 4% match
• A slew of other optional benefit offerings (short term disability, vision, dental)