Employer: Thirty Madison
The Role/What’s the Opportunity?
We’re looking for a Medical Billing Specialist to join our Medical Operations Team, within our Service Operations Department.
In this role, you will manage the day-to-day submission and follow-up of claims and Prior Authorizations submitted to patients’ insurance. You will be both patient and provider-facing, from shepherding patients through the benefits process, to coordinating with providers to ensure all claim information is accurate. You’ll provide efficient and effective support to the Customer Experience team, our providers, and patients across all of our brands. You must be comfortable speaking with others across various channels (email and phone) compassionately and professionally.
This position will report to the Medical Operations Manager – Billing & Administration, and will work cross-functionally within Service Operations to ensure best in class patient experiences.
This position will earn $18.50/hour.
What you get to do every day
- Coordinate with providers to attain medical necessity documentation to expedite PA and claims approvals and perform the appropriate follow-up
- Process all paperwork/forms related to medication prior authorizations, including electronic distribution (fax, web-site applications, and/or telephone)
- Validate patient’s insurance plans, prescriptions, and eligibility
- Review and submit claims to insurance payers. Verify accuracy and completeness of all required information prior to submission.
- Identify and review, code and abstract clinical information and assign correct ICD-10 & CPT codes
- Develop expertise on insurance processes, benefits, and exclusions to support patients in navigating billing inquiries or concerns
- Investigate insurance claim denials, exceptions, or exclusions. Take necessary action to resolve claim and payer issues in an effort to recover proper reimbursement.
- Other ad-hoc, medical-operations related tasks
What you bring to the role
- At least 1 year of medical administrative experience.
- Experience in medical billing or processing prior authorizations is preferred.
- Knowledge of Prior Authorization, ICD-10, and CPT terminology is a plus!
- Excellent communication skills, knowledge of general clerical duties, and cultural competency for communicating with people of various backgrounds
- Aptitude and enthusiasm to learn the ins and outs of a fast-moving startup in the healthcare world
- Superb judgment, the ability to think quickly on your feet, and deep empathy
Benefits for full-time Thirty Madison employees:
- Competitive salary packages and career development opportunities
- 100% coverage on many health, dental, and vision insurance plans
- 401k with a match, commuter benefits, and FSA
- Budget for the technology tools you need whether it’s a laptop, monitor, or special software
- Annual $750 vacation stipend and $750 wellness allowance