• Reimbursement Specialist - Medical Biller

    Job Locations US-MA-Wellesley
  • Overview

    HealthDrive delivers on-site dentistry, optometry, podiatry and audiology to residents in long-term care, skilled nursing and assisted living facilities. Each specialty offered by HealthDrive is one that directly impacts the quality of daily life for the deserving residents we serve. HealthDrive connects patients in need of vital healthcare to doctors committed to dignity and excellence.


    The Third Party Medical Biller is responsible for accurately and timely processing of assigned billing duties on a daily basis with the primary goal of sending a clean claim the first time to increase cash collections and reduce DSO.


    • Review, prepare and accurately bill for assigned charges on a daily basis
    • Perform manual billing for hardware orders from dispense paperwork within 24 hours of receipt
    • Identify and communicate billing corrections to providers and perform follow-up to ensure corrections are processed in a timely manner within established guidelines
    • Review, communicate and work with providers to resolve unbillable orders due to documentation not fully completed by providers and any other issues impacting the ability to bill for the charges in timely manner
    • Update data for assigned tasks on daily productivity tracking spreadsheet
    • Meet or exceed daily productivity objectives for all assigned duties
    • Process all billing and mail items on a daily basis in order to achieve cash collections and DSO objectives including but not limited to:
      • Process insurance changes from daily insurance spreadsheet on a daily basis, updates are to be completed within 48 hours of receipt
      • Review explanation of benefits from insurance payers for issues requiring follow up and resolution includes but is not limited to the following:
        • Claims denied for unable to identify patient /patient not covered on date of service
        • Conduct timely follow-up with insurance payers, patients, facilities to obtain corrected/updated billing information
        • Research incoming mail received with updated billing information or returned for incorrect mailing address and make required updates in billing system
        • Utilize insurance eligibility websites as needed to verify new insurance information received from patient, RP or facility prior to rebilling
      • Respond to email inquiries regarding billing related questions/issues within 24 hours.
      • Administrative tasks including but not limited to:
        • Assist with mailings, filing, processing refunds and document scanning

    Other duties and tasks may be assigned as appropriate or necessary


    Associate’s Degree preferred plus experience in 3rd party medical billing and/or collections. Experience and knowledge of healthcare and medical terminology, including but not limited to: CPT, ICD9 /ICD10 codes and use of modifiers. Experience in billing Medicare Part B, Medicare Replacement plans and Medicaid for large multispecialty physician practice preferred.


    The individual must have excellent attention to detail and strong data entry skills and with extensive knowledge of physician billing to Medicare, Medicaid and other insurance plans.   Also needed are excellent interpersonal and customer service skills and the ability to communicate effectively and appropriately both verbally and in writing. He/she should be highly organized, have the ability to work in a fast-paced environment, be comfortable and effective working with both custom and “off the shelf” computer applications. Familiar with and experienced using online tools and insurance carrier websites. The individual should be self-motivated with excellent time management skills and a proven track record of consistently achieving assigned objectives.   Must have ability to work effectively with minimal supervision who can work well independently and in a team oriented environment. Individual must have positive attitude and adapts to change well.   Must be fully proficient in using Microsoft Applications especially Excel, Outlook and Word.


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