About the Job:
An MMCD Biller is responsible for managing MMCD claims, from claim submission/billing to research on claim statuses, and providing timely updates to our onshore counterparts. This role involves meticulous documentation, email correspondence, and proactive inbound and outbound calling to ensure efficient resolution of MMCD claims issues. The ideal candidate will possess strong communication skills, exceptional organizational abilities, and a proactive approach to resolving claims discrepancies.
What You'll Do:
- Aging Management: Oversee the complete aging process for designated facilities, ensuring timely follow-up and resolution of outstanding claims through calls and emails.
- Claim Submission/Billing: Responsible for submitting claims via both paper and electronic methods, adhering to specific guidelines and requirements.
- Claim Dispute and Reconsideration: Handle claim disputes and requests for reconsideration, addressing discrepancies and facilitating resolutions.
- Appeals Processing: Prepare and send appeals when necessary, advocating for timely claim payment.
- Corrected Claims Submission: Process and submit corrected claims as needed to rectify claim issues
- Billing and Tracking Spreadsheet: Maintain accurate documentations and utilize tracking spreadsheets to monitor claim status and progress.
- Aging Management and Client Collaboration: Participate in internal aging meetings and liaise with clients to provide updates and address concerns regarding billing/claims issues.
- Posting Responsibilities: Execute posting activities for assigned facilities, including regular postings and $0 remittance postings.
- Cash Reporting and Bank Reconciliation: Manage cash reporting processes and ensure bank tie-outs are accurately reconciled.
- Bad Debt Management: Oversee the bad debt log and participate in the write-off process by preparing and processing write-off packets.
- MedForce Savings Tasks: Take charge of tasks related to MedForce Savings
What You'll Bring:
- Proficient in understanding Managed Medicaid and Traditional State Medicaid, procedures, and billing requirements.
- Familiar with using billing software and electronic health records systems or insurance portals.
- Knowledgeable about claim submission procedures/billing, including pre-authorizations and appeals.
- Able to efficiently identify and resolve issues related to claims.
- Possesses strong verbal and written communication skills to effectively interact with insurance companies, provider representatives, and onshore staff.
- Capable of prioritizing tasks and managing workload effectively in a fast-paced environment and under pressure.
- Can remain composed and focused during busy periods, consistently delivering accurate and efficient results.
- Demonstrate ability to collaborate effectively with colleagues in the billing department and cross-functional teams.
What we have to offer:
- A company culture based on our purpose to bring out the untapped potential, creativity, and success in people, partnerships, and brands.
- A culture built on the mission to develop high-functioning teams by providing an environment of constructive support and inspiration where people grow personally and professionally
- A market competitive total compensation/rewards package including: