Job Overview

Our client is seeking a detail-oriented and knowledgeable Medical Billing and Coding Specialist to join their team. In this role, you will be responsible for ensuring accurate billing, timely reimbursement, and compliance with healthcare regulations and payer requirements. The ideal candidate is analytical, highly organized, and experienced in navigating complex insurance processes and revenue cycle workflows and has familiarity and a proven track record in handling claims, denials, and authorizations.

Schedule

• Monday - Friday, 9:00 AM - 5:00 PM PST, with 1 hour unpaid break (40 work hours per week)

Independent Contractor Perks

• Health Insurance Coverage for eligible locations
• Permanent work from home
• Immediate hiring

Responsibilities

• Ensure that patients and insurance companies are properly billed for all services, and that payments are received and processed in a timely manner.
• Analyze Excel spreadsheets and raw data.
• Denial management process.
• Telephone insurance carrier/patient to seek resolution on accounts.
• Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts.
• Utilize specialized knowledge of contracts or regulatory or contractual billing guidelines to determine an account’s ability to pay after initial rejection from the payer.
• Coordinate duplicate billings, coordination of benefits, medical records, or clinical documents as needed to expedite payment of insurance claims.
• Identify trends in payer non-compliance and inform management if not able to resolve with the payer.
• Negotiate within specified guidelines with payers.
• Ensure secondary carrier is appropriately billed or self-pay portion is pursued. Follow up with appropriate staff to locate missing information.
• Ensure accurate and timely billing of all outstanding account balances to the appropriate third-party payers and patient guarantors.
• Maintain necessary logs.
• Participate in departmental meetings as necessary.

Requirements

• Proven experience as a Medical Billing Specialist.
• Knowledge of insurance policies, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Familiarity with medical terminology and experience with healthcare billing.
• Proficiency in EMRs, preferably eClinicalWorks.
• Strong attention to detail and commitment to accuracy.
• Excellent communication and problem-solving skills.
• High school diploma; certification in medical billing or a related field is a plus.
• Windows PC

Side Note

• This is a permanent work-from-home role under an Independent Contractor arrangement. Candidates must have their own computer and reliable internet connection, and are responsible for their own taxes and benefits. Professional hourly fees are established based on your performance in the application process.

Reminder

• Please follow the provided link to BruntWork’s Career Site to finish your initial application requirements, including the assessment questions, technical check, and voice recording. Submissions with all requirements fulfilled will receive priority review.