Medical Biller -
Company: AppleOne
Location: Durham
Posted on: January 26, 2023
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Job Description:
Duties and Responsibilities:Credentialing:Review and process
therapists initial credentialing packets and supporting
documentation. Follow up with therapists to ensure all information
is obtained.Complete and process payer enrollment applications for
therapists for Medicare/Medicaid/commercial insurances/managed care
or other plans.Complete timely follow up on all
applications.Maintain therapist profiles and NPI---s, CAQH and
internal spreadsheets.Ensure that re-credentialing is complete
timely to prevent any lapse in enrollment.Monitor and maintain
current documents (licenses, malpractice insurance).Maintain
confidentiality of all therapists informationBilling:Verify
coverage and eligibility for medical servicesPost charges and
payments to correct accountsObtain pre-authorization for certain
proceduresCommunicate with insurance providers, therapists and
clientsReview patient bills and correct any missing or inaccurate
informationUse billing software to prepare and transmit
claimsCollect unpaid claims and clear up discrepancies by
telephone, fax or email communicationUse of insurance carrier
portals for eligibility and claims informationInvestigate and
appeal claims that were deniedComplete data entry to update
spreadsheets and reportsWork with clients to set up payment
plansRequired Skills:Knowledge of insurance guidelines including
HMO/PPO, Medicare, Medicaid, and other payer requirements and
systemsCompetent use of computer systems, software and
EHR---s.Familiarity with CPT CodingExperience with behavioral
health billingExperience with behavioral health
credentialingEffective communication skillsExceptional Customer
Service skills for interacting with patients regarding medical
claims and payments, including communication with patients and
family membersAbility to work well in a team environmentAbility to
triage priorities and handle conflict in a reasonable
fashionProblem-solving skills to research and resolve
discrepancies, denials, appeals, collectionsMaintaining patient
confidentiality as per the Health Insurance Portability and
Accountability Act of 1996 (HIPAA)Ability to multitaskAt least 2
years recent medical billing experienceAt least 2 years
credentialing experienceCandidate must agree to a background check
AppleOne is proud to be an Equal Opportunity Employer. Pursuant to
applicable state and municipal Fair Chance Laws and Ordinances, we
will consider for employment qualified applicants with arrest and
conviction records.High School0-1 years
Keywords: AppleOne, Durham , Medical Biller -, Healthcare , Durham, North Carolina
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