As the Medical Billing Specialist, you will generate insurance claims and patient statement billings and collect outstanding insurance or patient balances. You are responsible for submitting billing with supporting documents using various delivery methods and expected to resolve submission issues, provide requested invoices, and answer inquiries regarding billing.

Please note: This position is not located in a patient care facility. It is located in a corporate office setting.

RESPONSIBILITIES

• Prepare, format and mail all insurance claims according to specific contract/payer requirements.
• Remain knowledgeable of third-party payer contracts, federal and state medical coverage programs and requirements as well as being knowledgeable on HIPAA regulations and guidelines.
• Complete claim follow-up calls on claims 30 days outstanding from the submission date.
• Perform claim appeal functions upon receipt of EOB's.
• Follow-up on outstanding claims with insurance carrier and patient for status including processing correspondence, resubmitted denied claims and claims that are inaccurately processed.
• Process all account refunds within 30 days of identification.
• Respond to inquiries in a professional manner that demonstrates and supports good relations with the community.
• Review accounts receivable aging report and perform follow-up as required for aged amounts outstanding.
• Review and process monthly billing statements.
• Recognize potential reimbursement issues as they arise and communicate status of issues with management.
• Make follow-up phone calls on accounts with outstanding balances.
• Perform other duties and responsibilities as assigned.

QUALIFICATIONS

• Experience with medical insurance plans and types of benefit coverage preferred.
• Experience working with ICD-10 and HCPC coding preferred.
• Experience with universal billing forms such as HCFA 1500 preferred.
• Knowledge of current coding practices in regards to billing and processing of Explanation Of Benefits, managed care contracts preferred.
• Ability to communicate effectively both verbally and in writing.
• Must have the ability to work independently to effectively and efficiently perform assigned duties.

WHY HELGET?

Helget Home Care and Capital Medical are Nebraska based Durable Medical Equipment companies with over 50 years of experience serving Nebraska and Iowa. We are committed to providing the highest level of care to our surrounding communities and are a preferred provider for over 300 health insurance carriers. Our mission is to be the first choice for quality medical products and services. We offer competitive compensation, health/dental/vision insurance, 401K with employer match, paid holidays, PTO, and more.

WHAT DO WE VALUE?

Commitment & Dedication, Honesty & Integrity, Team & Service to Others, Life Balance, Continuous Improvement