Medical Biller Lead - FT , 5+ Years Exp

About the position

The Medical Biller Lead position at PGM Billing, LLC is a full-time role focused on supporting the manager in various billing tasks within a medical billing company. The ideal candidate will have over 5 years of experience in revenue cycle management and will be responsible for handling billing tasks, denial management, and assisting staff in resolving issues. This role requires in-office work and emphasizes the importance of accuracy and communication in a fast-paced environment.

Responsibilities
• Support manager in account specific work such as billing out claims, working rejections and denials, posting payments, A/R follow-up and denial management.
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• Investigate complex denials that other staff may be unable to resolve by locating payer policies and evaluating coding problems.
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• Access insurance carrier portals or third-party intermediary portals to track down denial reasons and/or payment details.
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• Learn and master the use and functionality of the billing software, including the clearinghouse portal.
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• Make necessary updates to the practice management software or clearinghouse website to re-submit claims previously denied for payment.
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• Assign or identify appropriate CPT codes (ICD-9, DRG, ICD-10), diagnoses codes, and modifiers.
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• Verify patient insurance coverage.
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• Maintain confidentiality of patient information and adhere to HIPAA regulations.
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• Stay updated on changes in medical coding systems and billing procedures.

Requirements
• Minimum of 5 years of experience in medical billing or coding.
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• Proficiency in medical coding systems (ICD-9, DRG, ICD-10).
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• Knowledge of medical office procedures and medical collection practices.
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• Strong attention to detail and accuracy in coding and billing processes.
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• Professional communication skills with staff and providers.
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• Ability to work independently and meet deadlines in a fast-paced environment.

Nice-to-haves
• Experience with EHR systems
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• Organizational skills
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• Ability to work well in a team setting.

Benefits
• Health insurance
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• Dental insurance
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• 401(k)
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• Flexible spending account
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• Paid time off
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• Vision insurance
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• Flexible schedule
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• Life insurance

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