Billing Specialist _ CARES
Hanger, Inc. - Phoenix, AZ

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Overview:

Position is responsible for resolving systemic billing issues that cause claims to be rejected by payers. Responsibilities include root cause analysis, process improvement recommendations and regular reporting.

Responsibilities:
  • Conducts root cause analysis to isolate and correct system billing errors regarding coding and unique insurance company billing requirements.
  • Analyzes state insurance regulations to determine specific billing requirements for each state where the business unit has operations.
  • Develops systems for systematic monitoring and analysis of outcomes of billing and collections processes.
  • Maintain payer contracts in contract management software to ensure system is applying proper claims reimbursement methodology for accurate payment from both government and commercial payers.
  • Develops and generates information critical to the ongoing measurement, operation and improvement of the revenue cycle.
  • Compiles and analyzes contractual allowances in relationship to insurance contracts and government payor arrangements.
  • Provides monthly analysis to assist management with an understanding of net revenue realization rates.
  • Maintains and improves revenue collection, payment information and reporting with the use of the payer contract management system.
  • Performs analysis related to impacts of changes in government payment regulations and models contract negotiations for commercial payers.

Qualifications:
  • Associates degree or equivalent experience
  • 4+ years experience in medical billing, collections or related field
  • Highly analytical with strong systems orientation
  • Good understanding of accounting principles
  • Strong communication skills; presentations are clear and concise
  • Good understanding of insurance industry, key players, state & federal government contracts

Hanger, Inc. - 2 years ago - save job