Communicates insurance trends and unresolved appeals to the billing manager for further action. Research open claims and processes appeals when necessary. Prepares weekly and monthly reports of Medicaid billing for the Manager of Revenue Cycle Management and Medical Records.

Free, convenient parkingMEDICAL BILLING SPECIALIST (Medical Biller)A medical billing specialist (Medical Biller) is requiredto have knowledge and experience with Medicare and commercial insurances including third party administrators regarding all aspects of claims including payments, appeals, and working denials, and understanding the insurance industry benefits and familiarity with their websites.

Coordinates denials and appeals and/or reconsideration requests on clinical, coding and technical denials with PBS center, which may include outpatient RAC denials and appeals. Maintains denial and/or appeals logs and assessments in accordance with associated guidelines.

You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents. Serves as primary inside sales support for assigned Donor Recruitment District.

Develops and revises, as needed, Appeals Settlement Guidelines (ASG) for those coordinated ACI/SME issues determined to be factual in nature, specifically detailing facts which must be considered in the settlement of the issues.

Job Summary:Responsible for following up on physician medical claims including but not limited to following up on open submissions, investigating patient accounts, resolving denials quickly and accurately, fielding all incoming correspondence, and filling appeals/reconsiderations.

Responsible for appearances before the Workers Compensation Board, conducting depositions, drafting, and filing summations, appeals and rebuttals. We have an exciting opportunity for a remote Workers' Compensation Attorney.

Appeals: Administrative appeals of decisions issued by Administrative Law Judges in workers' compensation claims, and support for appeals to the appellate division, third department.

Responsible for following up on physician medical claims including but not limited to following up on open submissions, investigating patient accounts, resolving denials quickly and accurately, fielding all incoming correspondence, and filling appeals/reconsiderations.

Assists higher level auditor on audit work and appeals as assigned. The Auditor II will gain experience on Medicare Part A Audit and Reimbursement as part of our Medicare Administrative Contract (MAC) with the Federal Government (The Centers for Medicare and Medicaid Services (CMS) branch of the Department of Health and Human Services.

The medical billing specialist is required to have knowledge and experience with Medicare and commercial insurances including third party administrators regarding all aspects of claims including payments, appeals, and working denials, and understanding the insurance industry benefits and familiarity with their websites.

Following up on payment discrepanciesFiling appeals/reconsiderations as necessaryWork closely with staff in the skilled nursing facility. Following up on payment discrepanciesFiling appeals/reconsiderations as necessaryWork closely with staff in the skilled nursing facility.

Minimum Qualifications:Responsible for following up on physician medical claims including but not limited to following up on open submissions, investigating patient accounts, resolving denials quickly and accurately, fielding all incoming correspondence, and filling appeals/reconsiderations.