Carrier to Carrier Medical Billing Specialist

About the position

The Medical Billing Specialist is an integral part of the Carrier-to-Carrier team at The Rawlings Group. This position is crucial for the electronic and paper billing of medical claims, requiring a comprehensive understanding of various claim forms and coding requirements. The ideal candidate will possess a deep knowledge of clearinghouse requirements and rules, ensuring that all billing processes are executed accurately and efficiently. The role is designed for a full-time commitment, with a standard day shift of 40 hours per week. During the initial training period, employees will work from 8 AM to 5 PM, but after six months, there will be flexible scheduling options available between 7 AM and 7 PM based on performance. The work environment is professional, with opportunities for hybrid work from home arrangements after the training period. The Rawlings Group prides itself on providing exemplary training and development programs, equipping new employees with the necessary tools and knowledge to succeed in their roles. The compensation for this exempt position is competitive, complemented by a comprehensive benefits package that includes health and dental insurance, short-term disability plans, a 401(k) with company matching, and paid time off. Additional perks include access to an onsite gym, cafe, and coffee shop, fostering a supportive and engaging workplace culture.

Responsibilities
• Audit claims for procedure and ICD coding along with proper use of modifiers.
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• Correct rejected claims and resubmit them.
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• File medical insurance appeals.
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• Maintain and adhere to the responsibilities for our clearinghouse and their rules and regulations.
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• Maintain and record all communication with insurance companies and keep a follow-up schedule.
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• Communicate with insurance companies.
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• Perform other duties as assigned.

Requirements
• Bachelor's Degree preferred or equivalent combination of education and experience in health insurance or related fields.
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• At least two years of experience as a Medical Biller.
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• Comprehensive understanding of insurance EOBs.
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• Knowledge of insurance claim forms, including professional and institutional claims.
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• Knowledge of Medical Coding and Modifier placement.
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• Proficiency in Microsoft Word and Excel.
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• Professional oral and written communication skills, including excellent phone communication skills.
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• Strong organizational and administrative skills.
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• Ability to multi-task and work independently as well as within a team.
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• Excellent time management and analytical skills.
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• Strong attention to detail and organizational skills.

Nice-to-haves

Benefits
• Disability insurance
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• Health insurance
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• On-site gym
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• Dental insurance
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• Paid time off
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• 401(k) matching
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• Flexible schedule

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