Billing Specialist - Insurance

The Villages, FL

Full Time

6503 Powell Road, The Villages, FL

Experienced

About The Villages Health
The Villages Health is a patient-centered primary care driven, multi-specialty medical group with over 800 team members. Our unique care model gives us both the time and resources to truly care for our patients, along with a company culture that supports a healthy work-life balance for our team members. Our purpose, mission and vision is to empower Villagers and the surrounding communities to live out their dreams by keeping them healthy and healing them quickly. Together, we are changing the way healthcare is delivered and are making a positive difference in the lives of our patients and the communities we serve. In doing so, The Villages Health is creating America’s Healthiest Hometown.

Our Full-time Benefits
Medical, Dental & Vision Insurance | Matching HSA & 401k | PTO & Paid Holidays | The Villages Charter School Eligibility | & much more!

Hiring Event
Please bring your resume and join us:

Friday, January 17^th from 9:30 AM to 1:30 PM at The Villages Health Administrative Office (6503 Powell Road, The Villages, FL 34785) – RSVP’s are encouraged through Eventbrite at https://bit.ly/3VO31Gy

Responsibilities:
Accountable for the collection of receivables from the health plans and for reconciling the insurance balances on the patient accounts.

Submit pending and/or held claims for your designated insurance group for all facilities.
Contact insurance company (online/phone) on balances older than 30 days in submitted status.
Effectively utilize actions for account follow-up.
Work all denied claims, including held claims in Athena due to insurance rejection claim status, on a daily basis. Submit claims appeals or corrected claims as needed.
Reconcile A/R balances on insurance accounts. Follow-up with 3rd party payers on claims not paid according to contract.
Work old A/R to determine collectability.
Prepare insurance refunds, or process adjusted claims for payers to retract overpayment within 60 days.
Run aging reports in Athena to understand balances by payer.
Utilize Athena worklist reports to prioritize and effectively work A/R.
Respond timely and accurately to calls or correspondence from insurance companies.
Provide exceptional customer service to patients by responding to their inquiries in a timely and professional manner.
Monitor assigned Athena claim status’ on a daily basis to ensure timely claims processing.
Develop professional relationships with the claims department at the health plans.
Submit secondary/paper claims for assigned payer, if needed.
Other duties as assigned.

Education/Experience Requirements:

High School Graduate; some college coursework preferred. Two years’ experience and working knowledge in medical billing functions of third party payer systems including Medicare and commercial insurance. Previous experience in operation of office machinery including a copier, fax, computer and printer. Proficiency in Microsoft products including excel, word and outlook.

Salary is commensurate with experience.

Questions? Contact us at [email protected]

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I certify that I have read and understand the applicant instructions included with this application and that the answers given by me to the foregoing questions and statements made by me are complete and true to the best of my knowledge and belief.

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Billing Specialist - Insurance

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