Job Functions, Duties, Responsibilities and Position Qualifications:
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Location: Dallas, TX
Days: Monday-Friday
Hours: 40/week
Full Time: Benefit Eligible
In this role you will:
- Understand all aspects of the billing system to properly perform job responsibilities.
- Follow-up on outstanding A/R balances in a timely manner.
- Manage assigned accounts related to denials, claim rejections and unprocessed claims.
- Review payer correspondence and respond accordingly.
- Research denied claims thoroughly to determine proper resolution.
- Use proper appeals/reconsideration protocol specific to each health plan as required to further collections’ efforts.
- Research payer policies to ensure proper processing and resolution of denied claims and/or appeals.
- Contact insurance companies as needed for appeals/reconsideration status on outstanding appeals.
- Perform necessary adjustments as outlined by payer contracts and management.
- Ensure claims are processed according to network requirements and in alignment with ProPath’s contracts.
- Identify payer trends related to reimbursement issues, denial patterns, payment discrepancies, etc. to ensure quick resolution and maximize revenue.
- Back-up Patient Call Center as needed to ensure patient/client calls are handled in a timely and professional manner.
- Adequately meet and/or exceed monthly collections and productivity goals as identified by management.
- Work special projects as needed.
- Maintain confidentiality of employee, patient, client and company records and issues in accordance with HIPAA guidelines.
- Communicate effectively with all levels of management, co-workers, patients and clients to provide quality customer service.
- Special projects and other related duties as assigned.
- Provide quality internal and external customer service.
All you need is:
- Minimum 3 years medical billing experience required, specifically related to account receivable and denials management.
- High School diploma or equivalent. Some college helpful.
- Basic knowledge of CPT/ICD-10 and HCPCS codes, modifiers and CMS 1500 professional claims processing required.
- Ability to effectively communicate orally and in writing with payers.
- Knowledge of Medical Insurance claim processing a must.
- Familiarity with Microsoft software including Excel, Word, and Outlook. Incumbent must be detail oriented and have the ability to coordinate several projects simultaneously.
Bonus points if you've got:
- Pathology billing experience a plus.
- Familiarity with Medicare guidelines helpful.
Scheduled Weekly Hours:
40
Work Shift:
Job Category:
Accounts Receivable
Company:
ProPath Services, LLC
Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.