A rapidly growing physician owned medical group is looking for an experienced Manager to join the team.
The Medical Billing Manager/Medical Claims Auditor will be responsible for checking the claim for completeness, for compliance with procedures and to ensure that the costs are in line with the service or diagnosis received by utilizing online reference, Plan Summary Descriptions, Provider Contracts, and/or current coding manuals. Medical Claims Auditor must be experienced and extremely detail-oriented, precise and thorough. Accuracy is our main focus in this role. Knowledge of facility and ancillary claims processing experience is required. Knowledge of medical terminology is a must, as is a broad understanding of health insurance administration processes and standard guidelines. Knowledge of CPT, HCPCS, and ICD-9 Coding is essential.
- 3-5 years medical billing experience.
- CPC Certification required
- Manages the Professional Fees billing and collections to ensure accuracy, timeliness, and consistent cash flow.
- Responsible for the management of day to day reporting of billing functions to upper management; staffing of the department (which includes both billers and collectors); assuring all billing rules and regulations are followed; oversees all work and productivity for Professional Fees.
- Accountable for resolution of problems, denials, and appeals. Works closely with Revenue Cycle leaders in Centricity Practice Management Software, Cash applications, Revenue Management, and Managed Care.
- Claims processing, medical billing or related work skills required
- Knowledge of medicine and medical terminology, CPT, HCPCS, ICD.9, and DSM codes
- Must have experience with UB92 forms
- Strong knowledge of Medicare Billing & Payment Guidelines as well as CMS CCI Edits
- Familiar with all regulatory requirements including CMS and DHS
- Experience in coding and abstracting, working knowledge of Diagnosis Related Groups (DRGs), Private Payors, and Medicare coverage guidelines is required
- Strong experience in the analysis and processing of Medicare claims, utilization review/quality assurance procedures, ICD-9-CM and CPT-4 coding, Medicare coverage guidelines, and payment methodologies (i.e., CCI, DRGs, Prospective Payment Systems, Ambulatory Surgical Center), NCPDP and other types of prescription drug claims is preferred
- Must be able to work with little direct supervision
- Strong data entry skills (10,000 keys strokes alpha/numerical)
- Must be able to work on computer systems, accessing multiple files (Centricity and EMD’s preferred
$18.00 to $30.00/hour
Medical, dental, vision, life, STD, LTD, 401(k)
Qualified applicants should email resume
NO WALK-INS OR PHONE CALLS PLEASE!
Indeed - 20 months ago