Company & Location: A&R Medical Supply, 5010 Lomas Blvd NE, Albuquerque NM
Organization: Locally owned corporation established since 1994 with 5 locations and 50 employees specializing in home medical equipment and supplies for patient use.
Employment status: Full-time, 40 hours per week, M-F 8:00 am - 5:00 pm .
Pay: Starting at $17 per hour
Benefits: Medical, vision, dental, wellness, life, generous PTO, 401K and a fantastic, friendly work environment.
Employment: Our medical billing team encompasses professionals who submit timely claims, adjudicate denials efficiently, communicate with staff and medical professionals to ensure precise documentation is attained, collect patient portions in a fair manner, attain authorizations through the most efficient means and work with a sense of urgency with an overall departmental goal in mind.
Primary Job duties: Duties are assigned to individual desks within the billing department. All duties listed on this job description are required knowledge areas for every billing representative. However, primary duties are outlined for each desk in the department and are to be initialed by the responsible representative for acknowledgment.
- Is familiar with the rules and regulations regarding the type of coverage being billed. This includes HCPC and ICD10 terminology, rules and regulations/
- Verifies Insurance; Medicare, Medicaid eligibility.
- Requests assignment of benefits, prescriptions, letters of medical necessity, and other required information.
- Maintains accurate and complete records concerning billing activity.
- Communicates problems and concerns with supervisor/office manager, which may lead to inaccurate or untimely completion of reimbursement processing.
- Responsible for Quality Assurance (QA) for Rebill Patients
- Performs billing audits consistent with the company requirements & based upon the aging of accounts, dollar values, insurance payers or issues of non-payment.
- Missing documentation to be allocated quickly to the originator of the order & thereafter followed-upon to ensure timely resolution.
- Performs daily audit of patient invoices; identifies and adjusts any portion that is not patient responsibility. Collection calls will be made on any balance that is greater than 120 days. Performs monthly audit of patient statements and makes collection calls from said statements based on age and history of account.
- Continuously performs collection duties with regard to private & commercial invoicing based on company requirements. Aged & value balance of accounts are prioritized. Payments can be negotiated consistent with company policy & departmental directive.
- Responsible for posting Medical Insurance and Private payments. Further, responsible for properly posting Denials of payment for identification purposes. Communication of trends of payments & denials to the department & management for maximum effectiveness in DSO.
- Reviews all denials of the company, makes necessary changes to the claim and/or account then ensures resubmittance to the proper payer for appropriate & timely billing. Reviews audits and client documentation criteria as necessary in order to perform duties. Recognizes trends and underlying factors as to why claims may be denied and communicates with staff to ensure these issues are identified and acted upon to ensure payment.
- Coordinates the attainment of valid Certificates of Medical Necessity (CMN) for Medicare insurance billing. This will include:
a. the identification of accounts requiring CMN’s
b. insurance verification,
c. creation of CMN specific to the patient and their applicable services
d. Initial request to the authorizing physician
e. Additional request & continued, timely follow-up of each request.
f. Education of the authorizing physician’s office for proper & timely completion
g. Timely reallocation to another physician when attainment is not achievable.
The coordinator will maintain complete accounting of overall CMN’s required & outstanding for attainment. This will include reuthorization identification & attainment. Comprehensive notes as to communication are to be made available. Constant communication with the department & management for improved CMN efficiency required.
REQUIREMENTS
- 4 years clerical/office experience.
- Typing and 10-key skills.
- Excellent communication and customer relations skills.
- Detail oriented.
REPORTING RELATIONSHIP
- The Accounts Receivable Collections Specialist reports to the Accounts Receivable Manager
- Physical Requirements: 1-10 lbs. lifted infrequently. Sitting up to 8 hours per day. Standing up to 4 hours per day. Ability for data entry and processing while using a computer. Frequent telephone operation and communication ability.
Technological Requirements: Must be computer literate with basic typing and knowledge of Word, Excel and Outlook. Ten-key is preferred.
Job Types: Full-time, Part-time, Internship
Pay: From $17.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Weekly day range:
Experience:
- ICD-10: 1 year (Preferred)
Work Location: In person