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Central Billing Representative II
Ashbaugh Beal
Handles patient accounts receivable, communicates with insurance companies, resolves claim issues, and ensures payment.
16d ago
Junior (1-3 years)
Full Time
Albuquerque, NM
Office Full-Time
Company Size
22 Employees
Service Specialisms
Commercial Litigation
Construction Law
Corporate/Securities Law
Insurance Recovery
Intellectual Property
Property Damage Solutions
Sector Specialisms
Construction
Real Estate
Environmental
Employment
Property Damage
Corporate/Securities Transactions
Insurance Recovery
Commercial Litigation
Role
What you would be doing
claims editing
claims resubmission
a/r resolution
compliance monitoring
customer support
accounts adjustments
- Follow up on claims denials, make appropriate corrections, obtain approvals and resubmit claims denials for payment; appeal denials through the payer required appeals process.
- Initiate & complete account adjustments to correct account balance and/or comply with contractual and sliding fee scale requirements.
- Maintain current knowledge of regulations for Third Party Payers, Medicare, Medicaid and knowledge of claims coding and formats.
- Coordinate electronic patient statements monthly.
- Complete bad debt process based on FCCH procedure.
- Participate in billing Helpdesk customer support, by receiving, responding and documenting all incoming account inquiries including electronic, telephone and written correspondence related to billing issues.
- Research unpaid claims; contact patients to obtain necessary information to assist with the claims process; secure payments or negotiate payment plans.
- Review credit balance reports and prepare refund requests for overpayments.
- Follow up with outstanding A/R all payers and/or including self-pay and/or including resolution of denials.
- Edit & submit insurance claims for fee for service and prospective payment system reimbursement.
- Communicate payment terms and establish agreed-upon payment plans for overdue patients.
- Review and resolve all EOB’s including those without payment to initiate clean claim resubmission and claim reimbursement.
- Monitor payment compliance with terms of established plans with patients and insurance plan provider representatives.
- Handle patient inquiries, complaints and customer service issues.
- Reconcile, review, research, coordinate and justify changes to claim forms and submit completed claim forms to third party payers.
- Review assigned outstanding A/R to identify problems with various insurance payers (i.e. Medicare, Medicaid, Commercial, Contracts and Self-Pay). Perform all routine and special follow-up on all assigned payer type accounts to affect collection of patient and insurance account balances.
What you bring
cerner
ehr
coding
communication
problem solving
coder certification
- General knowledge of computerized practice management systems, preferably Cerner, Cerner Electronic Health Record System and E H R.
- Ability to learn billing and collection system within federally chartered community health centers (CHC) and RHI/UHI programs.
- Ability to work with others in a problem solving and team environment and to work alongside staff as needed.
- High school degree or GED.
- Machines, Tools, Equipment required to be operated: Capable of using office machines and personal computers for word processing, data entry and spreadsheet applications.
- Working knowledge of CPT, DSM V and ICD-10 preferred.
- Certified Coder (medical and/or dental).
- General knowledge of UB04, HCFA1500 and Electronic and Paper claim forms.
- PREFERRED LICENSE/CERIFICATIONS
- Ability to communicate effectively, both orally and in writing.
- Visual Acuity, Hearing, and Speaking: Must be able to read a computer monitor and outputs accurately. Must be able to clearly and accurately communicate for work, safety and compliance.
- Two years in billing/claims experience in healthcare setting or FCCH billing externship.
- Experience in a multispecialty clinic setting.
- Ability to work independently with minimal supervision.
- Ability to respond effectively to sensitive inquiries or complaints.
- Knowledge and familiarity with compliance program. Cooperate fully and comply with laws and regulations.
- Coder and/or Billing Certificate may be substituted with demonstrated proficient
- Knowledge of Medicare and Medicaid guidelines.
- Knowledge of HIPAA as it relates to medical, dental & behavioral health billing.
- Billing Certificate, the result of graduation from a certified billing school.
- Position requires a high level of accuracy and attention to detail.
- Knowledge of Federally Qualified Health Care billing and reimbursement preferred.
- Physical Effort and Dexterity: Good dexterity to operate personal computer and office equipment. Occasional lifting and carrying related to office duties.
- Proficient with computers and MS Windows software programs.
- Ability to communicate with tact and diplomacy with diverse groups of people including staff, providers, and insurance companies on behalf of the organization. Ability to display sensitivity to the patient population being served.
- Ability to work on a variety of assignments concurrently within established deadlines.
- MINIMUM EDUCATION AND EXPERIENCE
Information not given or found
Interview process
Information not given or found
Visa SponsorshipInformation not given or found
Security clearance- criminal record check
Company
Overview
- Founded with a focus on resolving complex business disputes and guiding clients through financial restructuring.
- Has carved out a niche in providing tailored legal solutions for clients facing high-stakes challenges.
- Offers a full spectrum of services for businesses involved in construction, real estate, and other high-risk sectors.
- Specializes in navigating clients through complicated commercial litigation, mergers, acquisitions, and bankruptcies.
- Regularly works with both public and private sector clients, offering strategic counsel for financial turnaround and risk management.
- Key areas include construction law, business litigation, corporate restructuring, and real estate transactions.
- Known for its practical approach and deep understanding of industry-specific regulations, making it a trusted advisor in complex matters.
- Has developed a reputation for handling cases that involve large-scale projects and transactions with high stakes.
- A unique blend of legal and financial expertise that allows them to provide integrated solutions across industries.
- Delivering high-quality legal services with integrity and professionalism.
- Commitment to client service and building long-term relationships.
- Innovation and adaptability to meet client needs and market demands.
- Teamwork, collaboration, and fostering a positive workplace culture.
- Providing a respectful and supportive environment for employees to grow professionally.
- Committed to reducing environmental impact and enhancing sustainability practices.
- Focus on energy-efficient practices and reducing waste in office operations.
- Adopting sustainable technology and practices for document management and energy usage.
- No clear net-zero target date or measurable sustainability goals published on official platforms.
- Values diverse perspectives to foster an inclusive work environment.
- Creates a workplace where all employees are treated with respect and given equal opportunity.
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