Overview: We are looking for an experienced Medical Billing Specialist to assist with old, denied, and rejected claims for our clinic. If you have a proven track record of resolving denied claims, appealing insurance decisions, and ensuring proper reimbursements, this position is for you. Our hybrid payment model offers a low monthly retainer combined with a percentage of collections for successfully recovered funds. Responsibilities: Claims Reconciliation & Follow-Up: Review and identify denied and rejected claims from previous submissions. Work directly with insurance companies to resolve issues causing claim denials or rejections. Communicate with insurance payers to clarify and correct claim details. File appeals and correct errors in coding or billing that have led to denials. Ensure that all claims meet insurance payer guidelines before resubmitting. Patient Account Resolution: Follow up on outstanding patient balances related to denied claims. Communicate with patients regarding the status of their claims and work to resolve any balance discrepancies. Handle patient billing inquiries and adjust accounts as needed. Revenue Cycle Management for Denied Claims: Ensure timely follow-up on all outstanding and unresolved claims. Work to optimize the revenue cycle by maximizing the amount of money recovered from denied or rejected claims. Provide updates and progress reports on the status of claims recovery to management. Maintain accurate records of all communications, submissions, and follow-ups related to denied claims. Documentation and Reporting: Keep detailed records of claim follow-ups, resolutions, and appeals. Track and report on the number of successfully recovered claims and payments. Create and submit monthly progress reports on collections and resolutions. Payment Structure: Base Retainer Fee: A fixed monthly retainer of $[Amount], paid to secure your services and ensure ongoing claim management. Percent of Collections: In addition to the base fee, you will receive a percentage of collections for any successfully recovered amounts from old, denied, or rejected claims (typically [X]% of recovered amounts). This means the more you recover, the more you earn. This compensation model rewards performance and offers high earning potential based on successful collections. Qualifications: Experience: Minimum of [2-5] years of experience in medical billing, with a specific focus on denied and rejected claims recovery. Proven experience working with Medicare, Medicaid, and private insurance payers to resolve billing issues. Solid understanding of insurance payer guidelines and medical coding (ICD-10, CPT, HCPCS). Skills: Excellent problem-solving skills with a focus on claims resolution and appeal processes. Strong organizational skills and attention to detail to manage multiple open claims. Proficient in medical billing software and EHR systems. Strong communication skills for liaising with insurance companies and patients regarding claim status and resolution. Certifications: Certification in Medical Billing (CPB) or Coding (CCS) is preferred but not required. Why Work with Us? Hybrid Payment Structure: This role offers a low monthly retainer to cover the initial cost, combined with a performance-based percentage of recovered payments from denied claims, giving you an opportunity to maximize your earnings based on success. Focus on Old Claims: This is a targeted position focused on recovering old, denied, and rejected claims, meaning you’ll be working on claims that have already been submitted and need professional intervention to recover lost revenue. Flexible Work Environment: This position can be done remotely or from our clinic, depending on your preference, and you’ll have the flexibility to set your hours to best suit your schedule. How to Apply: If you have a strong background in denied and rejected claims recovery, we would love to hear from you! Please submit your resume along with a brief cover letter explaining your experience with old claims, appealing rejections, and your success rate in recovering funds.
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Medical Billing & Coding Communications Customer Service Accounts Receivable Management Customer Support
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