Deskripsi Pekerjaan
Tahche is looking for a detail-oriented and experienced Senior Medical Billing and Claims Specialist to join our team. In this pivotal role, you will support a rapidly expanding U.S.-based mental health group practice, ensuring accurate and efficient revenue cycle management. Your expertise will be instrumental in maximizing reimbursement rates, reducing claim denials, and maintaining strict compliance with federal healthcare regulations. We offer a collaborative, remote-first environment where your professional skills directly contribute to the financial health of our clients. If you have a strong background in medical billing cycles and a passion for healthcare administration, we encourage you to apply.
Tanggung Jawab
- Manage the complete revenue cycle, including patient registration, insurance verification, and claim submissions to payers.
- Analyze and resolve complex medical claim denials and rejections to ensure timely reimbursement.
- Utilize Electronic Health Records (EHR) systems to accurately code medical services using ICD-10 and CPT guidelines.
- Collaborate directly with insurance payers to resolve billing discrepancies and manage appeals processes.
- Prepare and review monthly financial reports, aging accounts, and performance metrics.
- Maintain strict adherence to HIPAA privacy standards and internal compliance protocols at all times.
- Train and mentor junior billing staff on best practices and payer specific requirements.
Kualifikasi
- Minimum of 3-5 years of experience in medical billing, claims processing, or medical coding within a healthcare setting.
- Proficiency in major EHR systems (e.g., Epic, AthenaHealth, Cerner) and medical billing software.
- Strong working knowledge of medical coding standards (ICD-10, CPT, HCPCS) and payer rules (CMS, NCQA).
- Proven track record of managing high volumes of claims and reducing denial rates.
- Excellent analytical skills with a keen eye for detail and accuracy.
- Strong communication skills, both written and verbal, for interacting with patients and insurance carriers.
- Certification (CPC, CBCS, RHIA) is highly preferred.