Medical Billing & Collections Specialist – ASC, Surgical

This is a fully remote position, open to applicants in Alabama, +31 more states.

📋 Description

• Evaluate medical records to ensure documentation accuracy and assign appropriate CPT and ICD-10 codes to claims.

• Conduct or delegate audit reviews of coding and procedural specifications.

• Execute and supervise billing processes, including primary and secondary billing as well as rebilling.

• Implement necessary claim edits utilizing both internal and external software systems.

• Stay updated on rules and regulations pertaining to government payers, including Medicare, Medicaid, and VA.

• Review daily clearinghouse transmissions to confirm successful file transmissions.

• Collaborate with vendors to address workflow disruptions or recurring issues.

• Follow up on billed patient accounts to recover outstanding balances.

• Process payments via cash, credit cards, EFT, and third-party vendors.

• Analyze and adjudicate EOBs/RAs to assess whether the Surgery Center received correct payments.

• Manage denials and appeals to secure claim payments.

• Track KPIs related to the financial performance of the Surgery Center.

⛳️ Requirements

• High school diploma is mandatory.

• An Associate degree, relevant Trade School qualification, or Coding Certification is preferred.

• 2-5 years of experience in a medical setting is required, ideally in the surgical field.

• Strong understanding of medical terminology is essential.

• In-depth knowledge of CPT and ICD-10 codes is crucial.

• Capability to process outgoing claims, draft billing edits, transmit transaction files, and handle payments.

• Excellent typing skills are required.

• Proficient in computer usage, email, copiers, and Microsoft Office applications.

• EMR experience is necessary, covering both clerical and clinical functions.

• Familiarity with ASC billing is preferred.

• Understanding of billing rules and regulations across various governmental programs is essential.

• Knowledge related to commercial claim submissions is needed.

• Strong grasp of HIPAA guidelines is required.

• Ability to lift, carry, or push/pull up to 20 pounds, and occasionally over 20 pounds.

• Candidates must reside in one of the following states: AK, AL, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

🏝️ Benefits

• Comprehensive Total Rewards benefits and well-being programs.

• Competitive compensation package.

• Premium pay options, including shift and on-call pay.

• Incentive pay available for select positions.

• Annual increase opportunities based on performance.

• Paid Time Off programs.

• Medical, dental, vision, life, and Short- and Long-Term Disability benefits.

• Flexible Spending Accounts for qualified health care and dependent care expenses.

• Adoption assistance available.

• Paid parental leave offered.

• Defined contribution retirement plans with employer matching.

• Additional financial wellness programs.

• Educational Assistance Program available.