Medical Billing Specialist

American Family Care Ladera Ranch

  • Mission Viejo, CA
  • $18.00-23.00 per hour
  • Permanent
  • Full-time
  • 2 months ago
Benefits/Perks
  • Great small business work environment
  • Flexible scheduling
  • Paid vacation, health insurance, dental insurance, retirement benefit, and more!
Company OverviewAmerican Family Care (AFC) is one of the largest primary and urgent care companies in the U.S. providing services seven days a week on a walk-in basis. Our state-of-the-art centers focus on the episodic treatment of acute illnesses and injuries, workers' compensation, and occupational medicine. Each location is equipped with an onsite lab and in-house x-ray capability.AFC is the parent company of AFC Franchising, LLC (AFCF). This position works directly with a franchised business location. The specific job duties and benefits can vary between franchises.Candidates Must Have:
  • At least 2 years of experience in medical practice billing with exposure to working with denials, appeals, insurance collections, and related follow-up
  • Working knowledge of Local and National Coverage Determinations and payor policies, and how to use them
  • Must have ICD-10 and CPT coding assessment skills, CPC certification is preferred
  • Strong proficiency in MS Office applications (Word, Excel, PowerPoint), and computerized billing systems is required.
  • A patient-first, mission-oriented mindset
Duties:
  • Organize and prioritize all incoming claims and denials.
  • Evaluate medical claims and coverage policy documentation to determine validity for an appeal.
  • Responsible for ensuring and monitoring the effectuation of all decisions as a result of the follow-up of unpaid/denied claims with insurance carriers.
  • Responsible for adhering to health care billing procedures, documentation, regulations, payment cycles, and standards.
  • Work accounts to resolution.
  • Collection from patients and insurances.
  • Works collaboratively and effectively with all other departments and functions to maximize operational efficiency and service and ensure consistency in addressing appeals issues.
  • Work independently to identify and resolve complex client problems.
  • Work with leadership to develop appropriate policies and procedures.
  • Maintain current knowledge of healthcare billing laws, rules and regulations, and developments.
  • Comply with all applicable HIPAA policies and procedures and maintain confidentiality.

American Family Care Ladera Ranch