Top 2 Multiplan Jobs | SimplyHired

Medical Billing - Claim Follow-up & Resolution
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- $60,000 - $70,000 a year
- Full-time
- Background check
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Behavioral Health Negotiation Specialist
Indigo Billing —Costa Mesa, CA
- $20 - $25 an hour
- Full-time
- Research
- Mid-level
- Office
- Health insurance
- Dental insurance
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Medical Billing - Claim Follow-up & Resolution

Confidential
Boca Raton, FL

Quick Apply

Job Details

Full-time
$60,000 - $70,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Employee discount
Life insurance

Qualifications

Data visualization software proficiency
Overseeing health insurance pre-certification
Medical coding software
Phone communication
Medical coding guidelines
Data reporting
High school diploma or GED
Business intelligence tools
Zendesk
Microsoft Teams
Productivity software
Medical terminology
Client interaction via phone calls

Full Job Description

Job description

We are seeking an experienced Medical Billing - Revenue Cycle Management specialist to join our medical billing team. The ideal candidate will have a strong understanding of medical billing processes and terminology, experience in follow-up for Out-Of-Network providers, ensuring accurate and timely follow-up on billed claims.

Roles & Responsibilities:

Responsible for claims follow -up, Professional and Facility, from claim submission until final payment
Communicate with insurance companies regarding claim denials or underpayments
Utilize Payer Online Portals such as Availity, Cignaforhcp, UHC, Navinet, Emblem for claims status and eligibility verification
Send Medical Records to payers, filing reconsiderations and appeals
Utilize providers EMR’s to obtain Medical Records
Reading and understanding various payers EOB’s
Posting payments, writing off balances and sending statements to patients, when necessary
Communicating with 3rd party payers such as Multiplan, MARS and Zelis regarding OON claim negotiations.
Follow up on Pre-negotiated Agreements a/k/a Single Case Agreements
Review and verify accuracy of billing data utilizing Optum EncoderPro
Utilize medical collection systems to track and collect payments
Ensure compliance with all relevant coding and billing regulations
Effectively resolve complex issues, including payment research, payment recoupments
Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions

Experience & Requirements:

Knowledge in Multi-Specialty coding - CPT and ICD codes for many different specialties
Experience working with medical billing software like Imagine and ADS
Familiar with Gap (Network Deficiency) exception and prior authorizations process
Familiar with Federal IDR arbitrations process
Familiar with OON Provider Registration Process with various Payers
Knowledge of medical terminology (Hicfa, UB04, Tax ID, NPI)
Strong attention to detail and persuasive telephone skills
Excellent communication and interpersonal skills
Solid skill with Microsoft Office applications: Word, Excel, Teams, Power BI reporting, Zendesk
High School Diploma or equivalent

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Employee discount
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Job Type: Full-time

Pay range: $60,000 - $70,000 (annual Salary is Commensurate with Experience)

Ability to Commute:

Boca Raton, FL 33433 (Required)

Ability to Relocate:

Boca Raton, FL 33433 - Relocate before starting work (Required)

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Employee discount
Health insurance
Life insurance
Paid time off
Vision insurance

Ability to Commute:

Boca Raton, FL 33433 (Required)

Ability to Relocate:

Boca Raton, FL 33433: Relocate before starting work (Required)

Work Location: In person

Quick Apply

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