Billing Specialist - Central Business Office

Salary Range: $22.00 to $26.00 an hour

By adhering to Connecticut State Law, pay ranges are posted. The pay rate will vary based on various factors including but not limited to experience, skills, knowledge of position and comparison to others who are already in this role within the company.

COVID-19 and Flu Vaccine Considerations
Masks are optional for employees, visitors, patients, vendors, etc. All employees are strongly encouraged and recommended to obtain the COVID-19 vaccination routinely. Proof of annual flu vaccination is required for all employees.

PACT MSO, LLC is a management service organization that supports a large multi-specialty practice of providers. We are currently looking for an experienced Medical Billing Specialist who will be working in Branford Monday through Friday from 8:30am to 5:00pm. This is not a remote position.

The Medical Billing Specialist is a critical member of the team who is responsible for the review and submission of clean claims, researching insurance denials and having ownership of assigned accounts receivable for third-party claims. Superior customer service skills in this role are essential to support our patients and multi-specialty practices with collecting accurate insurance information, assigning financial responsibility and bringing account balances to zero.

Essential Functions:

• Ensure accurate entry of CPT/HCPCS and ICD-10 codes based on documentation.
• Prepare, review and submit clean claims to insurance
• Resolve payer-specific clearing house rejections.
• Work directly with the insurance company, healthcare provider, and patient to get claims processed and paid in a timely fashion.
• Submit appeal letters and provide supporting medical documentation upon request.
• Verify patients’ insurance coverage and assist with coordination of benefits.
• Support patients/guarantors by answering incoming patient phone inquiries.
• Perform self-pay balance outreach, make payment arrangements and send statements to collect on outstanding patient accounts.
• Collaborate with revenue team members and coders, front desk staff, practice supervisors.
• Miscellaneous Data

Skills and Knowledge

• Excellent customer service skills including written and verbal communication.

• Strong communication skills to create positive interactions with internal and external parties.
• Knowledge of HIPAA regulations and the ability to handle confidential information.
• Understanding of Medicare, Medicaid and third-party payer billing requirements.
• Working knowledge of common registration, billing and insurance claims follow-up practices.
• Familiarity with billing compliance and reimbursement
• Ability to quickly navigate and work within the electronic medical record, clearinghouse and payer websites.
• Ability to work independently and efficiently to meet established productivity

Education and Experience:

• High School diploma or equivalent
• 3 years of physician billing experience
• Epic experience preferred
• Clearinghouse experience to manage electronic claims