Medical Biller/AR Follow Up – FULLY REMOTE Position Available In Miami-Dade, Florida

TekSystems is currently hiring for several

FULLY REMOTE AR

Medical Billers, these positions can sit anywhere EST time zone.

MUST HAVE

5 years of medical AR Follow up billing experience, MUST have EPIC experience! Description

THIS PROJECT IS SLATED TO START 7/28/2025 AND RUN THROUGH 10/17/2025.

Potential to extend! The revenue cycle for Reference Lab was outsourced to another healthcare company and recently brought back in house as of December 1, 2024 . When it was brought this back in house, it was moved to a reference tax identification number which means it is being reimbursed as a true reference lab on 1500 claims, not UB claims. (The

CMS-1500

form is used for non-institutional claims by individual healthcare providers, while the UB-04 (CMS-1450) form is used for institutional claims by facilities like hospitals) The client has never billed this business in EPIC, so IT is currently building this out. The EPIC build for the Reference Lab is set to Go Live as of July 14, 2025 (this could change) Right now, Sentara has a team that is registering all Reference Lab patients in EPIC because the providers still need to get the lab results. However, they are not able to add all the diagnosis codes and CPT codes yet. They have been holding all claims since December 1, 2024. Sentara’s Reference Lab is generating about 110,000 claims per month. By the time EPIC goes live in July, they will need to bill out roughly 900,000 claims. Desired Future State

• Once the reference lab billing is live in EPIC, they wants to release the claims in phases 15,000 new claims released per day over a 3-month time frame TEKsystems will work out of an EPIC que and excel to finish up the lab patient registration process TEKsystems will be matching the diagnosis code for each encounter and attaching it to each CPT code on the claim TEKsystems will verify insurance and eligibility along with providing denial follow up with the payer All reporting will be pulled from EPIC Once it goes live in EPIC, claims will be bill out in a phased approach•about 15,000 claims per day.

It will take about 3 months to get all claims billed out (900,000 claims roughly) About 2-3 weeks after the claims get billed out, our team will work on

FOLLOW UP

for denials That is where the team will look at what comes back from the payers Denial on follow up

• FOCUS ON ELIGIBILITY DENIALS

• file correct insurance, etc. They will not be focusing on medical necessity denials because Sentara doesn’t think they will get these approved to pay out. The big thing our team will be working on are denials due to eligibility
• need to enter correct insurance info, etc. Should be easy fixes to then re-bill and get paid by insurance. The team will work in EPIC
• work ques and also off Excel Spread Sheets The EPIC module is EPIC Requisition