Medical Billing Specialist
Medical Billing Specialist
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Job Description
Job Details
Job Summary
Who We Are
Machinify is a leading healthcare intelligence company with expertise across the payment continuum delivering unmatched value transparency and efficiency to health plan clients across the country. Deployed by over 60 health plans including many of the top 20 and representing more than 160 million lives Machinify brings together a fully configurable and content-rich AI-powered platform along with best-in-class expertise. Were constantly reimagining whats possible in our industry creating disruptively simple powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
Location: This position will be hybrid with opportunity to work full remote after training as well as in our La Grange KY.
About the Opportunity
At Machinify were constantly reimagining whats possible in our industrycreating disruptively simple powerfully clear ways to maximize our clients financial outcomes today and drive down healthcare costs tomorrow. As part of the Carrier-to-Carrier team the Direct Carrier Billing Specialist is responsible for the electronic and paper billing of medical claims. They must have an in depth understanding of the different types of claim forms along with coding requirements. The Direct Carrier Billing Specialist will also need to have an understanding of clearinghouse requirements and rules.
What youll do
- Audit claims for procedure and ICD coding along with proper use of modifiers.
- Correcting rejected claims and resubmitting
- Follow clearinghouse rejections based on the assigned payers.
- Maintaining and adhering to the responsibility for our clearinghouse and their rules and regulations.
- Communicate any billing errors and trends identified per client.
- Communication with insurance companies.
- Performs other duties as assigned.
What experience you bring (Role Requirements)
- Bachelors Degree preferred or equivalent combination of education and experience in the health insurance related fields which would provide the necessary knowledge skills and abilities to successfully perform the work.
- At least two years of experience as a Medical Biller. Comprehensive understanding of insurance EOBs.
- Knowledge of insurance claim forms including professional and institutional claims.
- Microsoft Word and Excel required.
- Professional oral and written communication skills including excellent phone communication skills.
- Strong organizational and administrative skills.
- Ability to multi-task work independently as well within in a team.
- Excellent time management and analytical skills required.
- Strong attention to detail and organizational skills.
- Always displays professional behavior in dealings with clients members peers trainees Audit management and any other individual with whom this position interacts. This applies equally to personal written or telephone contact.
What Success Looks Like
After 3 months
You will have a strong understanding of the role.
You begin building relationships and collaborating with peers.
You develop effective time and priorities management.
You receive initial feedback about your performance and are using it to improve.
Youve gained confidence in your abilities and are starting to feel more comfortable in your role.
After 1 year
You have mastered the tasks and responsibilities of the position executing them with confidence and efficiency.
You have established a strong network of internal relationships and are recognized as a key collaborator.
Youve been entrusted with greater responsibility indicating the companys confidence in your abilities.
You see opportunities for career progression and personal development.
Pay range: This is a non-exempt position. Compensation will be determined based on several factors including but not limited to skill set and years of experience.
Whats in it for you
- PTO Paid Holidays and Volunteer Days
- Eligibility for health vision and dental coverage 401(k) plan participation with company match and flexible spending accounts
- Tuition Reimbursement
- Eligibility for company-paid benefits including life insurance short-term disability and parental leave.
- Remote and hybrid work options
At Machinify were reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity teamwork accuracy and flexibility. We do the right thing and we listen to the needs of our clients and their members. As tenured experts with unmatched experience we champion diverse perspectives that help us to better understand and serve our clients.
Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally abandoning silos to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations and we give back to our communities through dedicating days for volunteering. Together Machinify is making healthcare work better for everyone and were passionate about a future with better outcomes for all.
We are committed to equal employment opportunity regardless of race color ancestry religion sex national origin sexual orientation age citizenship marital status disability gender gender identity or expression or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable accordance with applicable state laws we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process please contact our People Operations team at. See our Candidate Privacy Notice at:
Required Experience:
Senior IC
Employment Type
Full-Time
Department / Functional Area
Key Skills
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