Medical Office Billing Clerk – Intermediate
Work Location: San Antonio, TX
We are looking for an experienced Medical Billing Clerk with strong administrative skills to perform medical insurance collection follow-up activities. The position requires clerical skills to appeal third party insurance claims to Medicare, Medicaid, Commercial Insurance carriers as well as Governmental payors.
Job Duties/Responsibilities/Functions(including but not limited to)
• Review claims that have been adjudicated by Medicare, Medicaid, Commercial, various HMOs as well as Governmental non- contracted payors for appropriate billing.
• Address denied claims by phone, mail and payor website for reprocess.
• Utilize various collection processes and submit appeals and resolve discrepancies.
• Follow-up on claims pended for medical necessity, and claims pending for supporting documentation and/or medical records by working with various teams such as clinic staff, registration staff, and coding staff to complete appeals.
• Identify payor specific patterns or trends regarding denials and report these to Management for communication to Medical Departments and Administrators.
• Make the necessary recommendations regarding billing and edit creation to reduce denials.
• Audit medical records to ensure compliance with the organizations coding procedures and standards according to the CMS Coding Guidelines and Official ICD9 / ICD10 Coding Guidelines.
• High School diploma or equivalent and 3-5 years’ experience in Medical Claims Collections and Denials.
• Proficient computer skills in applicable MS Office Programs. Working knowledge of Microsoft Office Programs- Outlook, Excel and Word preferred.
• Experience with medical records, billing/posting and medical terminology required
• Experience in Electronic Medical records required and EPIC software and Peoplesoft particularly desired
• Working knowledge of insurance rules and regulations as they pertain to Managed Care, Medicare, Medicaid, HMO's, Commercial Insurance Carriers and Governmental Payors.
• Experience with patient billing software is recommended.
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.