Medical Billing/Claims/Collections

Job Description

We are looking for a meticulous individual to join our team as a Medical Billing/Claims/Collections Specialist on a contract basis in Glastonbury, Connecticut. This role involves managing various aspects of medical billing, claims processing, and collections while maintaining compliance with contractual agreements and ensuring high-quality service delivery. If you have a strong understanding of healthcare terminology, claims processing, and experience with accounting software systems, this position offers an excellent opportunity to contribute to a dynamic team.

Responsibilities:

• Process and adjust medical insurance claims and appeals in line with company policies and procedures.

• Monitor and ensure compliance with contractual obligations, including deliverables, procedures, and renewal deadlines.

• Conduct quality assurance checks to guarantee compliance with service-level agreements and the accuracy of reports provided to clients and internal teams.

• Create and update financial batch records for processing by the finance department.

• Identify, research, and resolve claim-related issues, including requesting additional documentation as needed.

• Serve as a liaison between clients and the organization, fostering positive and effective relationships.

• Facilitate program meetings and conference calls, ensuring clear communication and productive outcomes.

• Provide timely responses to inquiries and complaints from clients, offering effective solutions.

• Recommend process improvements to enhance efficiency and service delivery.

• Collaborate with customer service team leaders and insurance benefits managers to address and guide resolution of various issues.• Certification in Medical Coding and Billing or equivalent experience in a related field.

• Proven experience in medical claims processing and familiarity with claims clearinghouses.

• Proficiency in accounting software systems, including Allscripts, Cerner Technologies, and Dynamic Data Exchange (DDE).

• Strong computer skills, including expertise in Microsoft Office Suite and database software.

• Bachelor’s degree in Account Management or a related field, or equivalent combination of education and experience.

• Exceptional project management, presentation, and leadership skills.

• Ability to work independently with high attention to detail and resolve issues efficiently.

• Excellent verbal and written communication skills, with the ability to manage deadlines and escalate issues when necessary.