Lakeview Clinic is a multi-specialty medical practice that provides the highest quality, compassionate, comprehensive, and cost-effective health care to our communities. You will be part of a team that values excellent customer service, teamwork, and a positive work environment. Lakeview Clinic is a fast-paced clinic seeking a professional, caring, and detail-oriented individual who can multi-task effectively.

Job Summary:

We are seeking an experienced Medical Billing and Collection Specialist to join our team. The ideal candidate will have in-depth knowledge of insurance claims processing, patient collections, and the appeal process. This role requires meticulous attention to detail, the ability to follow up on outstanding claims efficiently, and expertise in CPT and ICD-10 coding.

Key Responsibilities Insurance Claims Management:

Submit and track insurance claims to ensure timely reimbursement. Identify and resolve denied, rejected, or underpaid claims. Conduct thorough follow-ups on outstanding insurance balances. Process secondary and tertiary claims as needed.

Appeals & Denials Resolution:

Analyze and resolve claim denials through appropriate appeal processes. Draft and submit effective appeal letters with supporting documentation. Work with insurance representatives to clarify claim issues and payment discrepancies.

Patient Collections & Follow-Ups:

Monitor and follow up on patient balances to ensure prompt payment. Communicate professionally with patients regarding outstanding balances, payment plans, and billing inquiries. Generate and send patient statements/invoices. Collaborate with front desk and scheduling teams to verify patient insurance eligibility and collect upfront payments when necessary.

Billing Compliance & Accuracy:

Ensure claims are coded correctly with accurate CPT and ICD-10 codes. Stay updated on insurance policies, billing regulations, and coding guidelines. Assist in maintaining compliance with HIPAA and other billing-related regulations.

Competencies:

Effective written and verbal communication skills. Interpersonal communication skills Ability to establish priorities, work independently, and proceed with objectives without supervision. Ability to handle and resolve recurring problems. Basic bookkeeping skills Detail-oriented Confidentiality-Maintain patient, staff, and employee confidentiality. Comply with all HIPAA regulations. Customer Service-Friendly, cheerful, and helpful to patients and others. Ability to meet patients and others needs while following Lakeview policies and procedures. Detail Oriented-Ability to pay attention to details of a procedure or task. Flexibility-Ability to adapt easily to changing conditions and work responsibilities. Positivity-Display a positive attitude and is a positive agent for change. Teamwork-Work as a part of a team and collaborate with co-workers. Working under pressure-Ability to complete assigned tasks under stressful situations.

Education and Experience:

High school diploma or equivalent required, Associate's Degree in Healthcare or Business preferred. Minimum of 2 years

CPT & ICD-10

experience preferred Minimum of 1 year of Medical Billing, Medical Claims Processing, Accounts Receivable experience preferred.

Compensation and Benefits:

Wage Range:

$22.00 - $28.00 per hour Compensation decisions are made based off several factors including relevant work experience, education, certification, and licensure as well as internal equity. Wages are just one part of our employee compensation package. Lakeview Clinic offers benefits including medical and dental coverage, paid time off, 401(k), holiday pay, life insurance and other voluntary supplemental insurance coverages. Lakeview Clinic is an equal opportunity employer and does not discriminate based on race, color, creed, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, disability, age, marital status, genetic information, veteran status, or any other characteristic protected by applicable federal, state, or local law.

Job Type:

Full-time Pay:

$22.00 - $28.00 per hour

Benefits:

401(k) Dental insurance Flexible spending account Health insurance Health savings account Life insurance Paid time off Retirement plan

Work Location:

In person