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Medical Billing Specialist Job in Newark, Delaware

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Job Title: Medical Billing Specialist

Employer:Premier Medical Management Group
Job Location:Remote
Skills:Experience with eClinicalWorks,EPIC,& Allscripts a plus
Preferred Certifications:CPC
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location: Newark 19702, DE, US
* Note: This listing is for a remote position
Date Posted:12/9/2020
SCOPE OF POSITION: Ensure maximum reimbursement by timely and accurately filing claims, following up on insurance denials and monitoring aging AR while maintaining respect for the patient and compliance with all agencies, including government payers.

PRINCIPAL DUTIES AND RESPONSIBILITIES: Reviews pertinent records to determine appropriate diagnoses and procedure codes with applicable modifiers according to established guidelines to complete billing while maintaining coding compliance 

Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS - 1 500 form within 48 hours from date of service. 

Prepares and submits secondary claims upon processing by primary insurer for patients with dual coverage.  

Communicates with practitioners regarding questions about treatment or diagnostic tests given to patients with regard to coding procedures 

Answer inquiries regarding patient responsible portions, copays, and deductibles. 

Resolves patient complaints and/or explains why certain services were not paid or covered by insurance. 

Timely follow up on insurance claim denials, exceptions or exclusions 

Claim rejections from clearinghouse fixed and resent < 24 hours after rejection 

Follow up in <15 business days for all claims with no status from the payer 

Follow up at a minimum of every 28 days for all other outstanding claim balances 

Secondary payer rejections addressed an resent <48 hours notice of rejection  

Utilize weekly aging accounts receivable reports to follow up on unpaid claims aged over 90 days.

Prepares and submits appeal letters to insurance carriers when not in agreement with claim denials. 

Collect necessary information to accompany appeal.  

Regularly communicate with management to discuss and resolve reimbursement issues or billing obstacles


Carrie Tenney
Director of Revenue Cycles
Premier Medical Management Group
Phone: 302-449-7484

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