Medical Billing A/R Specialist – FQHC Experience Required

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

📋 Description

• Interpret and comprehend explanations of benefits to execute medical billing tasks.

• Familiarity with CPT codes, Modifiers, and ICD-10 codes is essential.

• Ensure all charges are recorded within 24-48 hours of receipt from physicians/providers.

• Make necessary adjustments to patient accounts, including address, name, telephone number, and insurance changes.

• Guarantee all claims are submitted electronically on a daily basis.

• Review and address claim edits and rejections regularly.

• Submit paper claims on a weekly basis.

• Distribute patient statements monthly or weekly, depending on volume.

• Post all insurance and patient payments within 24-48 hours of receipt, ensuring they are batched by date and balanced daily.

• Address all denials immediately upon receipt.

• Prepare and send appeals as necessary.

• Initiate insurance follow-up after 31 days for claims.

• Respond to telephone inquiries related to all medical billing matters.

• Forward copies of overpaid accounts to the Billing Manager for review.

• Manage patient accounts receivable in accordance with practice policy.

• Refer accounts to collections based on practice policy.

• Maintain strict confidentiality regarding patient private health information (PHI), disclosing only the information requested.

• Handle all electronic processes associated with claims submission, remittance posting, etc.

• Ensure that all practice records received are scanned into client folders on the company network drives.

• Perform additional duties as assigned by upper management.

⛳️ Requirements

• Must have a high school diploma or equivalent.

• Requires a minimum of 5 years of experience in medical billing, including at least 3 years in FQHCs.

• Proficiency in accounts receivable follow-up is required.

• Knowledge of medical billing systems is necessary.

• Experience with unpaid claims for all insurance payers, including Medicare, Medicaid, and Bureau of Workers’ Compensation.

• Advanced understanding of behavioral health insurance policies and carriers.

• Familiarity with local coverage determinations.

• Understanding of in-network and out-of-network benefits, as well as customary rates.

• Previous experience in a customer service role.

• Ability to meet deadlines, production targets, and work under pressure.

• Capability to read, comprehend, and follow both oral and written instructions; must adhere to multiple practice policies.

• Proficient in professional communication with patients and co-workers regarding all medical billing inquiries.

• Ability to communicate clearly and concisely, using correct grammar, spelling, and punctuation in notes and emails.

• Ability to multitask effectively.

• Competent in operating a telephone system.

• Proficient in using Microsoft Products (MS Outlook, MS Teams, Word, Excel).

• General knowledge of operating office equipment such as computers, copiers, faxes, and scanners.

🏝️ Benefits

• Exceptional health benefits.

• Ancillary benefits.

• 401(k) plan with company match.

• Generous paid time off policy.

• Seven paid holidays available immediately.