Job Description

Job Description

Medical Billing/Coding Specialist

Yes Mediate provides alternative dispute resolution services to individuals, companies, and communities. Our neutrals meet with parties in secure conference settings or in a hybrid environment when requested. Our panel of highly qualified and experienced Mediators, Arbitrators, Ombudsmen, and Facilitators assist parties in exploring and creating mutually satisfactory resolutions to conflict. Our company's ability to handle rapid growth while maintaining a peace-driven work environment is what makes it a sought-after place of employment. Our ideal candidate would be someone whose values align with the company’s vision to bring the spirit of peaceful and collaborative resolution to any conflict or dispute we encounter.

Our Company is committed to contributing to the growth of the Dispute Resolution Field and educating our communities on its benefits. To support this, we need exceptional support staff. One who has skills and experience, including confidence and initiative. Candidates should be able to carry out the tasks necessary to support Yes Mediate and represent its interests well. It is important to our CEO that every person, regardless of race, ethnicity, age, disability, gender, sexual orientation, or religion, be treated with dignity and respect.

The ideal candidate MUST:

• Be confident in their abilities and their role

• Be even-tempered and diplomatic when dealing with strong or complex personalities

• Maintain courteous and professional decorum inside and outside of the office

• Be successful in the decision-making process

• Know how to handle rapid suspense

• Be comfortable with and capable of moving through change and innovation

Duties & Responsibilities:

• Claim review

• Work assigned claim volume timely and efficiently with corporate timeframes

• Research, appeal, and resolve unpaid insurance claims.

• Respond to correspondence from insurance carriers and providers.

• Assist in determining case eligibility for dispute resolution processes.

• Code/Billing verification

• Reviewing explanation of benefits and correspondence

• Monitor and reconcile files/reports from managed care networks-and insurance-carriers ensuring correct reimbursement with contracted rates.

• Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursements to providers, managers, and staff.

• Understanding and staying informed of the changes with procedures, billing guidelines, and laws for specific insurance carries or payers.

• Frequent speaking, listening using a headset, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer.

• Performs other job-related duties as assigned.

Qualifications:

Associate or Bachelors’ degree preferred

•Minimum 3+ Years of experience with insurance follow up and insurance collections.

•Minimum 3+ years of experience with Ambulatory Surgery Center verification of benefits, billing, and/or collections. (Critical)

•Knowledge of both In Network and Out of Network Facility and Physician Claims.

•Strong communications skills in both oral and written.

•Experience in reading, analyzing and interpreting EOB’s is a must.

•Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Work Comp and Third Party is a plus.

•Ability to prioritize workload and handle multiple tasks.

•Analytical and problem-solving abilities, with a keen attention to detail.

•Excellent editing, communication, and organizational skills

•Resourceful and independent; able to work quickly and effectively with multiple tasks from multiple sources with little to no supervision

•Proactive self-starter with the ability to problem-solve

•Proficient with MS Office products, Adobe, and other business software

•Must be able to pass a criminal history background check.

Environment:

• Hybrid/Remote

• Monday – Friday work week

• Flexible schedules may be considered after a 90-day probationary period

• Domestic travel may be required 5% of the time

Compensation:

• Hourly employee, compensated at $20-$22 per hour

• Dental, Vision, Telehealth offered

• *Eligible for program bonuses and benefits after a 90-probationary period

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