• Revenue Cycle Specialist - Medical Biller

    Bay Street Orthopaedics & Spine
    Job Description
    Bay Street Orthopaedics offers exciting opportunities for the qualified candidate to join our rapidly growing organization. Serving our community since 1975, Bay Street Orthopaedics is a regional leader in orthopedic medicine that inspires better health through compassionate care, medical education/research, and neighborhood outreach. As we continue to grow, we are currently seeking a full time Revenue Cycle Specialist – Medical Biller who would like to be a part of a work environment that consists of supportive leadership, state-of-the-art technological resources, inter-professional teamwork, and innovative learning.
    While following excellent service standards, the Revenue Cycle Specialist – Medical Biller position will be responsible for the below essential functions:
    • Prioritize daily work to ensure achievement of established productivity and A/R goals.
    • Accurately post all payments by line item in a timely and accurate manner.
    • Documents account activity to reflect the current billing status of each patient account to ensure an accurate audit trail.
    • Verifies insurance and authorization requirements
    • Coding and loading office and hospital charges for assigned provider
    • Process refund forms for all accounts identified during posting as overpaid.
    • Monitors and performs follow-up on medical billing through review, investigation and communication
    • Effectively manage claims follow-up, aging and denial work queues to ensure maximum reimbursement for services provided.
    • Responds efficiently and accurately to denials received. Ensures necessary information is obtained and resubmitted as quickly as possible.
    • Initiate and track appeals following appropriate payer guidelines.
    • Utilize monthly aging accounts receivable reports to monitor and follow up on unpaid claims aged over 30 days.
    • Collects on outstanding claims from third-party payers according to department benchmarks.
    • Interprets government, commercial, WC, Auto and TPL remittance advices and makes appropriate corrections to unpaid claims for resubmission.
    • Report findings of positive and negative trends. Offer suggestions for improvement and develop action plan.
    • .Contacts appropriate departments and eligibility systems to obtain necessary information for billing purposes.
    • Follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO.
    • Credentialing providers with insurance companies
    • Responds professionally and timely to patient calls and third-party payer calls.
    • Works on special billing projects as assigned by the Billing Supervisor in conjunction with other billing responsibilities
    • Meets professional behavior expectations as evidenced by compliance with the following standards:
      • Meets all attendance and punctuality requirements to ensure proper coverage and quality service
      • Demonstrates an ability to resolve interpersonal and professional conflicts appropriately
      • Ability to formulate decisions and make judgments that are demanding and interpretative
      • Maintain patient confidentiality; comply with HIPAA and compliance guidelines established by the practice.
      • Performs other duties as assigned related to revenue cycle management.
    • High School Diploma or equivalent
    • 2-3 years of medical billing experience – Orthopedic experience is a plus
    Specific skills, knowledge and abilities:
    • Proven record of success in analyzing accounts and securing insurance reimbursement.
    • Strong verbal and written communication skills
    • Strong customer service skills and comfortable answering both patient and insurance company questions
    • Highly organized, detail oriented, and self-motivated
    • Able to analyze problems and strategize for better solutions
    • Ability to work independently as well as with a team are essential.
    • Microsoft Office and Windows based computer application
    We offer our employees an excellent total compensation package, including competitive wages, excellent benefits and growth opportunities. We believe in our team and your ability to do excellent work with us. Full-time benefits include 401k, PTO, paid holidays, medical, dental, optical, life, long & short term disability and opportunity for advancement. Please submit resumes to jackiem@baystreetortho.com. We look forward to receiving your resume.
    Bay Street Orthopaedics is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, or status as a qualified individual with a disability.
    Contact Information
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