Institutional & Profee Claims Biller – Medicaid

This is a fully remote position, open to applicants in United States.

📋 Description

• Execute comprehensive claims submission processes and manage follow-up and denial activities.

• Oversee daily operations of the hospital or clinic's business office, including patient billing, collections, interactions with third-party payers, and preparation of insurance claims.

• Address claims and denial queues effectively.

• Organize business office activities and personnel, encompassing patient billing, credit and collections, and data entry tasks.

• Suggest and implement enhancements or modifications to existing processes.

• Establish controls for proper submission, billing, credit, and collections practices.

• Follow up on approvals from third parties, billing inquiries, and collection of overdue accounts.

• Ensure timely and accurate billing in line with set procedures and third-party requirements.

• Achieve production and quality assurance benchmarks.

• Maintain high-quality customer service and safeguard confidential customer data.

• Enhance job knowledge through training opportunities provided by the company.

• Handle various paperwork and perform administrative tasks.

• Contribute to team initiatives.

• Support the manager in coaching, training employees, managing disciplinary actions, and following up on action plans.

• Ensure compliance among employees with dress code, attendance, and other organizational policies.

⛳️ Requirements

• Minimum of 5 years of experience in hospital billing, covering Charge Entry, Claim Review (prior to submission), Claim Submission, Claim Denials, and Claim Re-Submission.

• Required experience in processing both Institutional and Profee claims.

• Ideal candidates will have experience with Medicaid claims processing.

• Exceptional communication skills, both written and verbal, along with strong interpersonal abilities.

• Excellent organizational, multi-tasking, and time-management capabilities.

• Detail-oriented with the ability to follow issues through to resolution.

• Capability to work independently as well as collaboratively within a team environment.

• High School Diploma or an equivalent mix of education and relevant experience is required.

• Strong critical thinking, organizational, and time management skills with a keen attention to detail, accuracy, and follow-through.

🏝️ Benefits

• Enjoy the flexibility of remote work with a focus on work/life balance.

• Comprehensive benefits package, including a 401(k) plan.

• Generous vacation and leave allowances.

• 10 paid holidays each year.

• Employer-covered short-term disability and life insurance.

• Paid Parental Leave.