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Address and resolve registration-related issues such as insurance verification, demographic updates, and eligibility discrepancies to ensure accurate billing and claims processing.
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Minimum of 2-3 years of experience in medical billing, with a focus on insurance claims processing and TRICARE for Life billing. The role requires exceptional attention to detail, strong analytical skills, and a thorough understanding of medical billing procedures, particularly in relation to TRICARE for Life. Responsibilities: Insurance Claims Processing: Verify insurance coverage and eligibility for patients, particularly focusing on TRICARE for Life beneficiaries.
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Work with Billing Supervisor and VP of Revenue Cycle Management to communicate issues with service collection including but not limited to lack of insurance authorization, inconsistent insurance verification, issues with claims processing and credentialing barriers.
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The medical biller adds consistent value to the revenue cycle /DOM department by adapting to various situations with ease and by being flexible. In addition, by following up professionally to any billing related telephone calls and answer questions from patients, staff, and other interested parties within 24 hours of receipt, demonstrates the core values of AHF. Precision in the handling of refunds, overpayments on accounts and transfers payments to the appropriate account/accounts under management approval, maximizes the revenue to AHF.
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Monitor denials, returned claims, claim edits, and payer claim processing behavior to assist with identifying systemic issues that may require process improvement to strengthen the health of the Revenue Cycle as well escalating identified concerns to the PFS manager.
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Design and implement IT solutions that optimize the Revenue Cycle management for DME including order processing, document management, claims, reimbursement, and billing.
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BILLING SUPERVISOR POSITION SUMMARY Function as a subject matter expert in practice revenue cycle, to include coding and processing of claims and insurance credentialing.
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Review and processing of claims aging and denials as assigned to include claim tracers, corrected claim submissions, appeals, and consistent revenue flow. Professional Biller, Medical Reimbursement Specialist or Billing & Coding Specialist Certification.
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Req ID : 3257 Working Title : Revenue Cycle Specialist III-Government and Commercial Credits (Remote) Department : CSRC PB - Group Business Entity : Cedars-Sinai Medical Center Job Category : Patient Financial Services Job Specialty : Patient Billing Overtime Status : NONEXEMPT Primary Shift : Day Shift Duration : 8 hour Base Pay : $24.34 - $36.51.
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The biller will identify errors, discrepancies, or missing information within the claims documentation, working closely with the revenue cycle staff to correct any issues and improve overall claims processing efficiency.
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The ideal candidate will have a strong background in the Durable Medical Equipment (DME) industry and a deep understanding of the Order to Cash (OTC) process in the DME business, including order processing, claims, reimbursement, and billing.
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The Director will work closely with other PPIL departments including Medical Services, Finance and Public Policy; directly with PPIL's 17 health centers; and with PPIL's outside Revenue Cycle Management vendor to ensure all elements of the revenue cycle process are coordinated and communicated for maximum revenue capture.
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Previous experience in healthcare revenue cycle management, medical billing, or claims processing. Strong understanding of medical terminology, coding systems (e.g., ICD-10, CPT), and insurance billing practices.
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Function as a subject matter expert in practice revenue cycle, to include coding and processing of claims and insurance credentialing. Days and hours of work will be mutually agreed upon with the Revenue Cycle Manager.
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Demonstrated experience and significant knowledge of medical coding, billing and credentialing. 5 years medical billing experience, preferred. Certified Medical Biller preferred, Associates degree or equivalent course work, preferred.
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revenue cycle medical billing claims processing jobs in Phoenix, Oregon
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