Medical Insurance Biller (Out-of-Network) – Plastic Surgery & Ambulatory Surgery Center
Lampert MD Plastic Surgery is now looking to hire an experienced, detail-oriented Medical Insurance Biller to join our established plastic surgery practice and ambulatory surgery center. This position is ideal for someone who is highly organized, enjoys solving insurance challenges, and has experience maximizing reimbursement for out-of-network claims.
The ideal candidate is proactive, dependable, and committed to providing exceptional support while ensuring timely and accurate reimbursement.
Our practice is looking for bright, motivated, compassionate, and talented team players of impeccable integrity and a personable demeanor.
We strive to improve the quality of life for each and every one of our patients. We are committed to delivering the highest level of patient care and providing the ultimate level of customer service and safety.
Responsibilities
- Submit and manage out-of-network insurance claims for the doctor and the facility – ambulatory surgery center.
- Verify insurance benefits and eligibility.
- Obtain prior authorizations.
- Follow up on unpaid or denied claims.
- Prepare and submit appeals.
- Manage accounts receivable and aging reports.
- Communicate with insurance carriers regarding claim status
- Acquiring letters of agreement and single case agreements,
- Negotiating contracts and insurance payments for facility, doctors, surgical assistants, nurse practitioner
- Analyze insurance plan and patient deductibles. Weigh and present the potential insurance payment versus self pay options for team, staff and patients.
- Analyze and present the potential benefit of involving insurance with "combination" cosmetic and reconstructive surgery cases
- Lead team when communicating with patients regarding insurance, deductibles, patient responsibility, and other insurance matters
- Aid in monthly staff meetings and educate team on insurance related issues.
- Makes follow-up calls to Workers Compensation, Private Insurance and Contract Lien Carriers on all claims that are overdue.
- Review claims issues, makes corrections as needed, and rebill
- Sends appeal letters to Insurance Carriers that send an incomplete payment
- Accurate and timely filing follow up of resolution for all accounts receivable
- Assist in the processing of insurance claims including working denials from insurance companies
- Post insurance payments accurately.
- Identify billing trends and resolve reimbursement issues.
- Maintain accurate patient billing records.
- Work closely with the practice team to ensure efficient revenue cycle management.
- Assist patients with insurance questions related to out-of-network benefits.
Qualifications
- Minimum 2 years of medical billing experience (more preferred).
- Experience with out-of-network billing strongly preferred.
- TEAM PLAYER MENTALITY. Medical billing will be the dedicated responsibility, but helping the team with clinical and clerical work is also required when needed.
- Plastic surgery, other surgery or ambulatory surgery center billing experience is highly preferred. But all experienced billers encouraged to apply.
- Strong knowledge of:
- CPT, ICD-10, and HCPCS coding
- Commercial insurance claims
- Appeals and reconsiderations
- Prior authorizations
- Accounts receivable management
- Excellent organizational and communication skills.
- Ability to work independently and manage multiple priorities.
- Proficiency with electronic medical records and billing software.
Applicants may be subject to background and/or credit check.
Compensation & Benefits
We value great employees and offer a competitive compensation package that may include:
- Competitive hourly pay (based on experience)
- Performance-based bonus opportunities
- Paid Time Off (PTO) and paid holidays after a defined period
- Shared health insurance coverage after a defined period
- Profit-sharing program after a defined period
- Supportive, team-oriented work environment
- Long-term career growth opportunities
We’re Looking For Someone Who:
- Has Integrity. Takes ownership of their work.
- Pays close attention to detail.
- Is dependable and professional.
- Self – starter and can figure out solutions sometime on their own
- Enjoys solving difficult insurance issues.
- Wants to be part of a practice that values integrity, teamwork, and excellence.
To Apply
Please submit your resume along with a brief cover letter describing your experience with medical billing, particularly any experience with out-of-network claims, plastic surgery, or ambulatory surgery center billing.
Please: Describe your experience with out-of-network medical billing, including the types of specialties you’ve worked in and your experience with insurance appeals and accounts receivable.
We look forward to meeting motivated professionals who are passionate about helping patients while ensuring accurate and timely reimbursement.
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Pay: $22.00 - $28.00 per hour
Benefits:
- 401(k) matching
- Health insurance
- Paid time off
Work Location: In person
