BILLING SPECIALIST I

Job Duties and Responsibilities:Research and investigate denied claims and contact carriers to problem solve & fully resolve claims in a timely manner to reduce Days in AR.Conduct claim scrubbing and submission & work claim edits.Be able to understand and assess medical records and supporting documentation for services billed against coding guidelines and payer requirements.Proactively provide feedback to A/R Manager and team regarding denial trends or workflow issues impacting AR.Communicate daily with providers and clinic staff on A/R trends.Maintain strict confidentiality within medical practice and HIPAA compliance, productivity goals set by the department and/or manager, and standard quality measures.Skills and Abilities:Experienced coding knowledge in ASC (Ambulatory Surgery Billing) is required. A high level of analytical and problem-solving skills is expected. Must be detail-oriented and organized.Accountability and Self-Management: Position is remote but will require traveling to office on occasion as required.A self-starter capable of tracking to deadlines and meeting goals with little supervision required.Working knowledge of Athena preferred (as well as industry standard online tools such as Availity, NPI Registry Lookup, CMS, and various payer online portals.)Excellent communication, customer service, and organizational skills, takes a proactive and professional approach to discussing issues and trends with the team.Experience in Excel, use of sorting/filtering, pivot tables & V-Lookups to analyze data.Ability to work autonomously in a remote environment and as a team player, and approach challenges with a positive attitude.Qualifications and Education RequirementsHigh school diploma/GED. Coding Certification highly preferred.MUST have Ambulatory Surgery Center billing experience.Understanding of medical terminology, denial remark codes, contracts, medical coding, and experienced knowledge of ICD10, CPT, HCPCS codes and modifiers.Minimum 3 years prior experience in physician professional billing and ASC Billing (Managed Care, Commercial and or CMS Part B claims adjudication), including any cross training in any other medical office roles such as front desk, insurance verification, referral coordination, etc.Must have experience with Explanation of Benefit forms (EOBs), insurance carrier billing requirements, payer & medical policies, and credit balances (discounts and refunds).StrideCare offers a total rewards benefits package that includes:Major medical insuranceDental and vision401kLong- and short-term disabilityPTOPaid holidaysNo weekends, evenings, nights, or holidays (paid holidays)Excellent work - life balance (Monday - Friday work schedules)Employee Assistance Program and more!

Created: 2025-02-08