**About Us**

At Remote Team Solutions, we specialize in creating exceptional teams for forward-thinking companies, helping businesses save over 60% on employee salary and benefit costs while eliminating the time and resource burden of active employee management and reducing staff turnover rates.

**Our Client**

We partner with a leading provider of high-quality intraoperative neurophysiological monitoring (IONM) services.

**Responsibilities**

• **Billing SOP Compliance**: Adhere to established protocols and guidelines for each payer and follow verbal instructions from the Billing Operations Director.
• **Investigation and Resolution**: Investigate why payer claims are not on file, why claims were not processed electronically, and ensure no duplicate claims are sent.
• **Case Review**: Review all assigned cases until closure as per the Billing SOP.
• **SOP Updates**: Update the Insurance Billing SOP with the most recent information and processes for assigned carriers.
• **Insurance Communication**: Call and speak with insurance companies after reviewing the EOB or claim notes to ensure prompt payment of assigned claims.
• **EBO Review**: Review EOBs for assigned claims to determine if an appeal, reconsideration, or correction is necessary, verifying that the modifier, CPT codes, and ICD-9/ICD-10 codes are in the correct order.
• **Medical Record Verification**: Ensure medical records match the claim form before sending records to insurance companies.
• **Appeal Letters**: Create appeal letters and gather supporting documentation to investigate if appeals are completely denied or if only one item is denied.
• **Proactive Claim Resolution**: Proactively search for all possible reasons why a claim may be considered incomplete and work to resolve it.
• **Documentation**: Document all steps performed on each account immediately in the billing software as per the Billing SOP, including documenting that medical records were sent and received by fax or certified mail with acknowledgment of receipt.
• **Claim Verification**: Verify and appeal, if necessary, all assigned claims that have not been paid according to the calculations of Senate Bill 418.
• **CRM Database Updates**: Update the insurance payers' CRM database, including contact information, payer preferences, and any other information that may assist in future collection processes.
• **Communication Guidelines**: Adhere directly to all communication guidelines as per specific requests from the insurance payer.
• **Patient Assistance**: Work with the Patient Care Advocate to enlist patient assistance with the claim.
• **Professional Communication**: Communicate with patients and payers with the utmost respect and professionalism.
• **Insurance Fraud Investigation**: Investigate insurance fraud and report it to the Billing Director and then to the company's board member as needed.
• **Additional Tasks**: Perform other tasks as assigned.

**Requirements**

• **Experience**: 2 or more years of experience in Accounts Receivable in Hospitals, Insurance Companies, or Medical Billing.
• **Knowledge**: Experience in managing accounts receivable, accounting, or billing in the medical field. Knowledge in the administration and follow-up of collections from clients, insurers, and medical entities.
• **Skills**: Ability to resolve invoice discrepancies and coordinate with other areas to solve financial problems.
• **Education**: Bachelor's degree in Accounting, Finance, or related field.
• **Language**: Conversational English (indispensable).
• **Software Skills**: Good Excel skills.
• **Soft Skills**: Excellent organizational skills and attention to detail.