Senior Medical Billing Specialist

About the role

Hirehangar is on the lookout for a Senior Medical Billing Specialist to become an integral part of the Revenue Cycle Management team at Rooted Life. This position involves overseeing the entire billing process, with a strong emphasis on submitting claims, resolving denials, and ensuring that clinical documentation adheres to compliance standards.

Key facts

What you'll do

• Prepare and submit accurate claims for various service lines, including ECM, Community Supports, and Housing Navigation.
• Cross-check claims with clinical data in Ritten.io to confirm the correctness of service timelines and patient eligibility.
• Address and rectify clearinghouse errors and claim rejections on a daily basis.
• Oversee the entire process of resolving denied or unpaid claims by directly communicating with insurance payers.
• Monitor denial patterns and report any systemic issues to the Revenue Cycle Manager for further action.
• Ensure that encounter notes and signatures comply with CalAIM standards for documentation.
• Maintain accounts receivable aging reports and assist in reconciling payments at the end of each month.
• Collaborate with Authorization Specialists and clinical staff to fill in any documentation gaps that may arise.

Requirements

• A minimum of 3 to 5 years of experience in medical billing, claims follow-up, or payer resolution.
• In-depth knowledge of CPT, HCPCS, and ICD-10 coding, along with familiarity with Medicaid or Medi-Cal billing regulations.
• Proven experience in managing claims through clearinghouses and handling denial management systems effectively.
• Ability to work independently and efficiently within US time zones, ranging from EST to PST.
• Strong technical proficiency in Excel or Google Sheets, including the use of VLOOKUP and pivot tables for data analysis.
• Excellent communication skills, particularly for resolving disputes with payers in a professional manner.

Nice to have

• Previous experience with the Ritten.io Electronic Health Record (EHR) system would be advantageous.

Skills & tools

• Ritten.io
• Medical Billing
• Denial Management
• Claims Processing
• ICD-10/CPT/HCPCS Coding
• Excel/Google Sheets
• CalAIM Compliance

Practical notes

To be considered for this position, candidates must complete the entire application form. Additionally, a recorded video is a required component of the initial interview process; applications submitted without a video will not be reviewed.

In this role, you will play a crucial part in ensuring that the billing process runs smoothly and efficiently. Your expertise will help maintain the financial health of the organization while ensuring compliance with all relevant regulations. The ideal candidate will be detail-oriented, proactive, and capable of managing multiple tasks simultaneously.

As a Senior Medical Billing Specialist, you will be expected to stay updated on the latest changes in billing regulations and coding practices, which will be essential for maintaining accuracy in claims submissions. Your ability to analyze denial trends will not only help in resolving current issues but will also contribute to improving the overall billing process.

This position offers a unique opportunity to work remotely from Santiago, Chile, while being part of a dynamic team dedicated to enhancing the revenue cycle management for Rooted Life. The compensation range reflects the importance of this role within the organization and is competitive within the industry.

If you are a motivated professional with a strong background in medical billing and a passion for improving healthcare financial processes, we encourage you to apply. Your contributions will directly impact the efficiency and effectiveness of our billing operations, ensuring that patients receive the care they need without unnecessary delays in processing their claims.

Join us at Hirehangar and be part of a team that values expertise, collaboration, and innovation in the healthcare billing landscape. We look forward to reviewing your application and potentially welcoming you aboard as our next Senior Medical Billing Specialist.