Medical Biller Specialist

Greenbelt, MD
May 08, 2021
May 10, 2021
Full Time
Job Description Cash Hawks only Apply: If you truly believe you are the CEO of your assigned AR. then TCG wants you! The Medicare Billing specialist will work with the Inpatient, physician and specialty billing team and support all claim and variance review of all client Accounts Receivables. Investigates and implements all current billing regulations on the state and federal level. Implements appropriate billing and collection procedures, ensuring that the inpatient and outpatient accounts receivable system records are kept in accordance with established procedures. Performs the inpatient and outpatient billing, and collections operations. Implements controls to ensure appropriate submission, billing, and payment cycles. Reinforces procedures for follow up on third party approvals, billing, and collection on overdue accounts. Answers all inquiries from patients or responsible parties regarding to their accounts. Performs all other duties assigned by the TCG manager or Client. Performs billing and collections of accounts receivable Perform billing in Scrubber system; work all edits Expertise in Medicare FISS system Review and correct all billable claims in billing software in accordance with payor specific guidelines and billing requirements within one working day. Work with HIM and applicable departments to resolve questions related to modifiers, orphan CPT/HCPCS codes, charge entry errors, ICD-10 and CPT/HCPCS coding errors, and other questionable claim form elements such as discharge disposition. Perform timely and appropriate follow-up to resolve unbillable claims. Document in account notes all reasons for billing delays and actions taken. Apply the appropriate hold reason code in billing software. Process secondary billing in accordance with department procedures. Every time an account is accessed, review and correct all account discrepancies, update demographics and other field values such as mnemonic, insurance and billing information, etc., to ensure data integrity in the billing software. Review all high dollar claims and perform follow up to correct payor for processing. Prepare and submit appropriate billing attachments as required by specific payors. Mail paper claims to appropriate payors- primary, secondary and appeals) Review daily claim rejection reports, resolve rejection issues, and resubmit corrected claims to billing scrubber and directly to payor claims systems through the client/hospital patient accounting system. Collaborate with Director of PFS to resolve claim submission delays exceeding criteria set by Director of PFS and/or VP of Revenue Cycle. System Expertise: FISS Nthrive, Change Health EPIC, Allscripts, Cerner, Meditech, Greenway Company Description Established in 1999 and rebranded in 2001, The Chappelle Group Corporation (TCG) has built a successful consulting practice working in both the commercial and federal sectors. TCG is a healthcare performance improvement and professional services provider which focuses on achieving financial and operational sustainability for clients through revenue cycle optimization. Headquartered in Greenbelt, Maryland and with clients in over 15 states and territories, TCG has earned a reputation for customized customer solutions, integrity, expertise and results. TCG provides commercial and federal sector professional services and products including: Clinical Services and Clinical Management Patient Access Management Software and Business Analytics Compliance and CDM Management Clinical Coding and Documentation Management Interim Management/Staff Augmentation Recovery and Collection Services Financial and Business Solutions Accounting, Financial and Performance Audits Budgeting Financial Management Business Information Services Program Management Services