averhealth is seeking a highly motivated Medical Billing Manager to assist the Corporate Operations office in Richmond. The Medical Billing Manager is responsible for working with insurance companies, treatment providers, and patients to ensure that averhealth’s medical claims are paid and processed appropriately. The Medical Billing Manager will also assist the accounting team with successfully navigating contracting and credentialing processes for third party payors. The ideal candidate will possess recent medical billing and claims processing experience for a hospital, clinic, or a third-party medical billing administrator.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Process insurance claims via third party payor billing portals or CMS 1500 forms as necessary.
- Research payor portals for newly credentialed third party payors.
- Work directly with the insurance company, treatment provider, patient service centers, and patients to get claims processed and paid.
- Review and appeal unpaid and denied claims.
- Assist with third party payor credentialing applications.
- Work with third party payors to complete contracting requirements.
- Research availability of referring providers in key business areas.
- Assign and sequence appropriate codes upon review of the billing information.
- Determine course of action for assigned codes and prioritize work accordingly.
- Comply with all applicable state, federal, and insurance regulations, including HIPAA.
- Seek advice and guidance from accounting team members and others as needed.
- Perform other duties as assigned.
EDUCATION AND EXPERIENCE
- Bachelor degree in accounting, health information management or related field required.
- Minimum of five years of medical billing and coding experience required.
- Current CPC, CCS-P, or equivalent coding certification preferred.
KNOWLEDGE, SKILLS AND ABILITIES
- Proficient skills in EMR and electronic billing system and assessment and problem solving
- Knowledge of general accounting principles
- General knowledge of accounting systems, especially QuickBooks
- Skilled in the use of computers, especially in operating Microsoft and web-based software
- Strong attention to detail
- Ability to prioritize work and take initiative
- Analytical, assessment, and problem-solving abilities
- Ability to work both independently and as part of a team
- Ability to communicate effectively both orally and in writing
- Ability to multi-task
- Strong organization, planning, and time management skills
- Ability to function effectively in a high-volume, fast-paced environment
- Ability to handle and maintain confidential information
COMPENSATION AND BENEFITS
- Compensation based upon experience and qualifications
- Health Insurance
- Vision Insurance
- Dental Insurance
- Life Insurance
- Short-Term Disability
- Long-Term Disability
- 401(k) with Company Match
- Paid Time Off
- Community Outreach Pay
- Employee Referral Bonus
- Ample Opportunity for Advancement!
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments.
All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills aptitudes and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills or abilities.
This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.