Billing Specialist

MedAmerica

Posted 3 months ago

Full Time

Modesto, California

Remote OK

Smart Summary

Responsibilities

The Billing Specialist is responsible for verifying insurance coverage, processing billing exceptions, and identifying correct financial classifications. They analyze pre-submission errors and communicate trends to the leadership team to improve billing operations.

Qualifications

You have a high school diploma or GED and at least one year of experience in billing operations, ideally within the healthcare industry. You should be proficient in understanding payer financial classifications, processing billing exceptions, and interpreting Explanation of Benefits (EOB) from various payers.

Must Have Skills for ATS

Explanation of Benefits (EOB)

Microsoft Office

Excel

Outlook

Word

Job Description

Remote, Nationwide – Seeking Billing Specialist

Everybody Has A Role To Play In Transforming Healthcare

As a Billing Specialist, you play a vital role in our mission to improve lives. As part of Billing Operations, you will be verifying insurance coverage of payers, identifying account classification, process billing exceptions, and more. At Vituity we know the impact you can have.

Join the Vituity Team. At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.

Vituity Locations: Vituity has opportunities at 890 practices across the country, serving 14.5 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

  • Identifies the correct Financial Class and enters in billing system.
  • Posts extracts and correct validation errors in system.
  • Identify trends and communicates to leadership team.
  • Reviews incoming documentation to identify correct payer to accounts.
  • Researches eligibility to ensure correct insurance coverage of payer.
  • Ensures payer mapping (crosswalk) is set-up correctly.
  • Identifies contract matrix discrepancies and/or gaps and communicates accordingly.
  • Analyzes decision log errors related to the daily census.
  • Identifies trends with incoming data and communicates to leadership team.
  • Analyzes pre-submission errors to identify root cause and recommends a solution.
  • Processes denials related to eligibility to identify correct payer or payer request.
  • Processes electronic rejections, identifies root cause, and recommends/makes appropriate updates to accounts.
  • Processes returned mail, write-off accounts, and daily exception reports.
  • Processes Laserfiche folders (duplicate, pending review, etc.) to ensure documentation is processing timely.
  • Identifies Work in Process (WIP) and creates exception reports for management.
  • Processes activity codes for Account Classification or account suspended issues.
  • Retrieves missing documentation for payer accounts from various applications and/or site portal.
  • Prints, sorts, and files miscellaneous billing related documentation.
  • Completes daily log via manual entry into billing system.
  • Time tracking for manual sites.
  • Trains fellow team members as requested or needed.

Required Experience and Competencies

  • High school diploma or GED required.
  • One or more years of experience in billing operations required.
  • Prior experience working in the healthcare industry preferred.
  • Knowledge of payer Financial Classifications for billing.
  • Knowledge of account exception processes in billing operations.
  • Ability to read and interpret Explanation of Benefits (EOB) from various payers.
  • Ability to communicate trends to leadership team clearly.
  • Ability to problem solve challenges that may not be previously outlined in a payer manual.
  • Ability to communicate effectively in writing and verbally.
  • Ability to analyze, interpret, and create various billing related reports.
  • Knowledge of and ability to apply basic math concepts.
  • Ability to complete duties with attention to detail and high degree of accuracy.
  • Ability to prioritize workflow and work autonomously.
  • Basic understanding of Microsoft Office applications (Word, Excel, and Outlook).
  • Ability to comply with RCM billing policies and procedures.

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

  • Monthly wellness events and programs such as yoga, HIIT classes, and more.
  • Trainings to help support and advance your professional growth.
  • Team building activities such as virtual scavenger hunts and holiday celebrations.
  • Flexible work hours.
  • Opportunities to attend Vituity community events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more.

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

  • Superior health plan options
  • Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
  • Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%25 plus discretionary profit-sharing contributions (eligible January following 18 months of service)
  • Generous paid time off starting 3-4 weeks’ annually
  • Student Loan Refinancing Discounts
  • Professional and Career Development Program
  • EAP and travel assistance included
  • Wellness program
  • Purpose-driven culture focused on improving the lives of our patients, communities, and employees

We are excited to share the base salary range for this position is $17.12, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company’s annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.

MedAmerica

CEP America announced in January that it has unified with its subsidiaries MedAmerica and MedAmerica Billing Services Inc. as Vituity—the next step in our journey of transforming acute care. For over 40 years, Vituity's Practice Management team (formerly MedAmerica) has provided expertise to physician groups, hospitals, and other healthcare organizations. We are healthcare executives, nurse consultants, and business professionals who work hand-in-hand to complement and support our providers'​ clinical expertise. Follow our new profile: https://www.linkedin.com/company/vituity-practice-management//.
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