Job Title: Sr Medical Billing Specialist

Type: Full Time

Location: Sunnyvale, CA

Salary Range: $75K - $100K per annum

Job ID#: 139981

Responsibilities:

• Confirm patient benefits and insurance eligibility by making calls to the insurance provider
• Follow and adhere to all regulations and guidelines set by Medicare, State programs, HMO/PPO, etc.
• Engage in end-to-end billing process, including charge entry, claim submission (including 837's and 1500 forms), payment posting, and accounts receivable management and extract reports from billing software
• Engage in follow-ups with insurance companies and medical groups to address outstanding claims and denials, ensuring the resubmission of claims & appeals for payment
• Develop, implement, and execute departmental procedures and processes
• Collect reimbursements and analyze the revenue data to report trends related to errors & denials
• Use data to identify trends, areas for improvement, and opportunities for revenue growth
• Generate insurance reimbursement reports and analytics on key billing metrics, providing insights into the internal and external stakeholders on financial health of the organization
• Analyze and identify opportunities to optimize revenue capture and reduce revenue leakage
• Ensure compliance with healthcare billing regulations and stay current with changes in billing and coding guidelines to ensure accurate and compliant billing practices
• Conduct detailed data audits and clean-up as scheduled and as needed
• Analyzes patient billing records for completeness and accuracy and obtains additional information and clarification as necessary
• Conduct billing training for internal and external stakeholders and maintain adequate documentation of meeting
• Implement strategies to improve claim acceptance rates reduce denials and enhance the overall billing experience for customers
• Collaborates with internal teams, supporting the efforts and needs of other departments in a team-oriented approach. Works closely with IT teams to implement technology enhancements aimed at improving billing efficiency.
• Resolves billing discrepancies by conducting further research and correcting errors
• Maintain organized documentation of all billing and invoicing activities
• Sending out invoices and maintaining a tracking system of incoming and late payments
• Following up on late or missed payments and initiating late payment notices to relevant parties
• Adjusting patient bills by reviewing remittance advice
• Maintain compliance with HIPAA (Health Insurance Portability and Accountability Act of 1996)
• Perform other related duties as required or requested

Job Requirements:

• Bachelor's degree in accounting, health care administration, finance, business, or related field, with 8+ years of experience in an office environment or healthcare-related field
• Knowledge of CPT/ICD-10/HCPCS codes and EHR systems such as EPIC, Kareo, eCW, Office Ally, Practice fusion, Athena, AdvanceMD, etc.
• Proficient in medical terminology and insurance plans
• Experience with process improvement, quality control, data analysis, and/or reporting
• Integrity and respect for confidentiality and privacy
• Attention to detail and the ability to work with a variety of databases
• Demonstrates the ability to work independently, is self-motivated, and self-directed with excellent verbal and written communication and documentation skills
• Demonstrates strong organizational and time management skills, enabling effective prioritization of workflow to meet client requirements.
• Possesses excellent customer service skills to ensure client satisfaction.
• Ability to analyze problems and devise strategic solutions
• Experience with using Google Docs, Sheets, Slides and Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel)

Preferred Qualifications:

● Certification in Healthcare Billing and Management

About Us:

Founded in 2009, IntelliPro stands as a global leader in talent acquisition and HR solutions. Our commitment to delivering unparalleled service to clients, fostering employee growth, and building enduring partnerships sets us apart. With a dynamic presence in the USA, China, Canada, Singapore, Philippines, UK, India, Netherlands, and Germany, we continue to lead the way in global talent solutions.

IntelliPro, a global leader in connecting individuals with rewarding employment opportunities, is dedicated to understanding your career aspirations. As an Equal Opportunity Employer, IntelliPro values diversity and does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other legally protected group status. Moreover, our Inclusivity Commitment emphasizes embracing candidates of all abilities and ensures that our hiring and interview processes accommodate the needs of all applicants. Learn more about our commitment to diversity and inclusivity at https://intelliprogroup.com/.

Compensation: The pay offered to a successful candidate will be determined by various factors, including education, work experience, location, job responsibilities, certifications, and more. Additionally, IntelliPro provides a comprehensive benefits package, all subject to eligibility