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Position Summary
The Medical Billing Specialist reports to the Supervisor of Revenue Cycle Billing and will be responsible for a variety of tasks requiring data analysis, knowledge of insurance and billing regulations, client and health insurance contracts to support reimbursement and collections methodology. This individual will focus on maintaining quality of medical billing for insurance verification, claim edits and claim processing. This individual will work closely in coordination with RCM (Revenue Cycle Management) leadership to ensure billing productivity and quality metrics are met for reimbursement and AR follow up.
Role and Responsibilities
- Meet department production and quality standards
- Meet project and assignment due dates and deadlines
- Manage inbound calls from members / internal service partners that are related to claims adjudication issues
- Research and resolve any open requests for either insurance and/or member refunds
- Escalates claim resolution to management when necessary
- Review all patient information and postings, prior to claims submission
- Submit claims to insurance carriers
- Analyzing denials and outstanding claims to determine appropriate remediation actions to resolve root causes and reduce/eliminate denials
- Follow up to see if claims are accepted or denied
- Investigate rejected claims, denial resolution review
- Verify insurance coverage and maintain accurate member eligibility status in our database
- Help automate existing processes and learn new systems
- Maintain the privacy and security of all confidential and protected health
- information
- Performs other duties as assigned
Skill Requirements/Preferences
- Associate degree preferred, or equivalent industry experience
- Minimum 2-3 years of medical billing experience
- Demonstrated ability to accurately calculate figures and reconcile accounts
- Demonstrated verbal, written and interpersonal skills, with an affinity for teamwork
- Organizational, multi-tasking and time management skills, with excellent attention to details
- Comfort and success working in a fast-paced environment with tight deadlines
- Demonstrated ability to proactively identify and resolve issues
- Experience with medical coding and billing systems
- Experience with telehealth billing preferred
The base salary range for this position is $55,000.00-$65,000.00. In addition to a base salary, this position is eligible for a performance bonus and benefits (subject to eligibility requirements) listed here: Teladoc Health Benefits 2024. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions.