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Medical Biller -

Company: AppleOne
Location: Durham
Posted on: January 26, 2023

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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