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Job Description
Developmental Pathways is seeking an experienced Medical Biller with experience in ABA services to work in our administrative office. The ideal candidate will have a strong background in medical billing, with the skills necessary to improve our current billing procedures and reduce A/R days. The successful applicant will work on a number of tasks requiring data analysis, in-depth evaluation and exercising judgement within the appropriate scope of practice. We offer excellent benefits, generous paid time off and competitive compensation.
Responsibilities:
· Audits and corrects all claims on UB04 and/or CMS 1500 format. · Review all EOB’s received in the mail that require attention. · Complete data entry of all patient demographics, guarantor, and insurance information. · Post procedures and insurance. · Manage relationships with various Insurance payers. · Call insurance companies to resolve billing issues. · Call for Verification of Benefits. · File claims to ensure maximum entitled reimbursement. · Follow orders of detailed work activity. · Ensure all claims are submitted with a goal of zero errors. · Verify completeness and accuracy of all claims prior to submission. · Meet all deadlines given. · Read and interpret insurance explanation of benefits. · Respond to inquiries from insurance companies, patients, and providers. · Regularly meet with Financial Manager to discuss and resolve reimbursement issues or billing obstacles. · Attend monthly staff meetings and continuing educational sessions as requested. · Perform additional duties as requested by Director or Management team. · Obtaining referrals and pre-authorizations as required for procedures. · Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing. · Following up on unpaid claims within standard billing cycle timeframe. · Checking each insurance payment for accuracy and compliance with contract discount. · Calling insurance companies regarding any discrepancy in payments if necessary · Identifying and billing secondary or tertiary insurances. · Researching and appealing denied claims. · Setting up patient payment plans and work collection accounts. · Updating billing software with rate changes. · Updating cash spreadsheets and running collection reports.
Qualifications:
· High School Diploma/GED required. · Minimum 2 years’ experience as a Medical Biller. · Experience in ABA service codes required. · Experience with NPA codemetro and Office Ally. · Proficiency with electronic medical records (EMR) · Strong knowledge of MS Access · Ability to work independently and collaboratively within a team environment · Able to multi-task and meet tight deadlines · Excellent problem-solving skills
License:
· Driver's License (Required)
Typical start time:
· 9AM
Typical end time:
· 6PM
Pay Frequency:
· Bi weekly or Twice monthly
Pay:
· Hourly: $18 to $23 (upon knowledge and experience)
Schedule:
· Monday to Friday · Day shift
Company's website:
· www.dpica.com
Work Remotely:
· No