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Medical Claims Specialist

hace 2 meses

Monterrey, Nuevo León, México Mordor Staffing A tiempo completo
Medical Billing Specialist Opportunity

We are Mordor Staffing, a concierge outsourcing firm for small to medium-sized USA businesses in Medellin, Colombia. Our mission is to provide top-notch careers for our clients, not just jobs. Our compensation packages are among the best in Colombia, and for good reason.

Job Summary

The Medical Billing Specialist will be responsible for resolving insurance claim denials for assigned lines of business. This involves generating effective online and written appeals to carriers using well-researched logic to recoup reimbursement on incorrectly denied claims. This includes appealing to payer denials through coding review, contract review, medical record review, and carrier interaction.

Key Responsibilities
  • Manage insurance A/R, including timely filing and follow-up of denied claims.
  • Call insurance companies regarding any discrepancy in payments when necessary.
  • Perform contractual analysis on paid claims to ensure accurate reimbursement and payment integrity.
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements.
  • Prepare claims for submission, including charge entry and submission of electronic claims.
  • Identify trends in denials and opportunities for improvement in the billing process.
  • Experience utilizing insurance web portals, such as Availity, UHC, Cigna, Medicare, and Medicaid.
  • Familiarity with CPT, ICD coding, LCD, and NCD.
  • Experience with CMS 1500 and/or UB04 billing formats.
  • Payment posting, anesthesia billing, and OON claims experience is a plus.
Benefits

We offer a remote job with a standard 40-hour workweek, Monday to Friday. This is a full-time, permanent position with a competitive salary of $26,000.00 per month.

We are looking for a medical billing professional with at least 1 year of experience in medical billing. Fluency in English is required.