Job Description
Job DescriptionWe are looking for an experienced Billing Clerk to join our team on a long-term contract basis in Taunton, Massachusetts. In this role, you will play a vital part in managing medical billing processes, ensuring accuracy in claims reconciliation, and maintaining strong communication with insurance representatives. The ideal candidate will have a background in healthcare billing, preferably with experience in behavioral health.
Responsibilities:
• Perform claims reconciliation for Mass Medicaid, including addressing approvals or denials and resolving any discrepancies.
• Conduct research to identify and resolve issues related to billing and insurance claims.
• Manage medical billing processes, ensuring timely and accurate submission of claims.
• Maintain patient insurance and demographic records, ensuring all information is up-to-date and accurate.
• Collaborate with insurance representatives to address claim-related issues and improve communication.
• Provide guidance to program directors and clinicians regarding billing procedures and specifications.
• Generate and review aging reports to monitor claims and ensure compliance with payer filing deadlines.
• Analyze high balance accounts and report any account activity concerns to the Billing Manager.
• Stay informed about payer specifications and independently research requirements.
• Utilize clearinghouse systems, such as Inovalon, for efficient claim processing.• Proven experience in medical billing, with a preference for candidates familiar with behavioral health.
• Strong understanding of healthcare billing practices and insurance claim processes.
• Proficiency in using computerized billing systems and clearinghouse platforms.
• Ability to perform detailed claims reconciliations and resolve issues independently.
• Knowledge of payer specifications and timely filing requirements for claims.
• Excellent organizational skills and attention to detail for maintaining accurate records.
• Effective communication skills to liaise with insurance representatives and internal teams.
• Familiarity with clearinghouse systems like Inovalon is highly desirable.