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Kforce Medical Billing Specialist in Plano, Texas

Kforce has a client in search of a Medical Billing Specialist 2 in Plano, TX.Summary:This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability. The main function of a medical biller is to submit medical claims to insurance companies and payers such as Medicare and Medicaid. They will be responsible for the timely submission of technical or professional medical claims to insurance companies. The location of this position may be in physician offices, hospitals, nursing homes, or other healthcare facilities.Job Responsibilities:

  • Follow up of outstanding A/R all payers and/or including self-pay and/or including resolution of denials

  • Responsible for working EDI transactions and ERA files, including reconciling carrier submissions, edits and rejection reports

  • Research and resolve accounts appearing on Delinquent Insurance Report, Collection Ledger and Government Payor report as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement

  • Obtain referrals and pre-authorizations as required for procedures

  • Check eligibility and benefit verification; Review patient bills for accuracy and completeness and obtain any missing information

  • Prepare, review, and transmit claims using billing software, including electronic and paper claim processing

  • Check each insurance payment for accuracy and compliance with contract discount

  • Call insurance companies regarding any discrepancy in payments if necessary

  • High School diploma or equivalent

  • Knowledge of business and accounting processes usually obtained from an Associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred

  • Must have 1 years of Healthcare (Hospital or physician) related AR experience

  • EPIC experience is a plus

  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid Follow up on unpaid claims within standard billing cycle timeframe

  • Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems

  • Effective communication abilities for phone contacts with insurance payers to resolve issues

  • Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds

  • Able to work in a team environment

  • Problem-solving skills to research and resolve discrepancies, denials, appeals, collections

  • Knowledge of accounting and bookkeeping procedures

  • Knowledge of medical terminology likely to be encountered in medical claims

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.Compensation Type:HoursMinimum Compensation:16.00Maximum Compensation:16.00

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