Please note that applicants must be located in Alaska to be eligible for an interview for this position.
Summary of Job Functions:
The Medical Biller at The Arc of Anchorage ensures accurate and timely medical billing processes. This position involves reviewing claims, assigning appropriate CPT and ICD-10 codes, preparing and submitting claims, and reconciling payments using The Arc of Anchorage’s electronic medical record system. Minimum of 2 years of experience in medical billing, with specific expertise in Medicaid billing.
Essential Job Functions:
- Review Claims:
- Thoroughly review claims for accuracy and completeness
- Obtain any missing information necessary for successful billing.
Claim Preparation and Submission:
- Prepare, review, and transmit claims using billing software.
- Follow up on unpaid claims within standard billing cycle timeframes.
Payment Accuracy:
- Check insurance payments for accuracy.
- Contact insurance companies to address discrepancies in payments when necessary.
Secondary and Tertiary Insurances:
- Identify and bill secondary or tertiary insurance as applicable.
Denial Management:
- Monitor and analyze claim denials, rejections, and underpayments.
- Investigate and resolve billing discrepancies and claim issues.
- Resubmit corrected claims and follow up on appeals to ensure timely resolution.
Compliance and Documentation:
- Maintain thorough knowledge of state and federal Medicaid billing regulations.
- Ensure compliance with HIPAA and other relevant patient confidentiality regulations.
- Document all billing activities, communications, and claim statuses in the billing software system.
Coding Expertise:
- Assign ICD-10 and CPT codes to claims.
Service Authorization Support:
- Assist in service authorization requests for behavioral health services
Continuous Improvement:
- Stay informed on updates to Medicaid policies, billing procedures, and industry best practices.
- Participate in training sessions and professional development opportunities.
Knowledge, Skills, and Abilities:
- Knowledge of CPT and ICD-10 coding
- Knowledge and understanding of billing procedures.
- Knowledge and understanding of HIPAA rules and regulations.
- Able to understand and explain EOBs.
- Knowledge of primary and secondary coordination of benefits
- Able to work in an integrated team.
- Knowledge of general billing processes and procedures required to resolve claims for payment.
- Intermediate understanding of Microsoft 365 applications
Education and Experience:
- High School Diploma or GED: Required.
- Minimum of 2 years of experience in medical billing, with specific experience in Medicaid billing
- Proven track record of handling claims, denials, and appeals successfully.
- Behavioral Health Billing Experience or Healthcare Reimbursement Education: Preferred.
Required Licenses, Clearances & Training:
- Background checks as defined by licensing agencies.
- Current TB test/clearance
- Valid driver’s license and proof of insurance
- Pass mandatory agency training (i.e., CPR, Mandt, Programs).
Physical Requirements:
- Sitting in a normal seated position for extended periods
- Finger dexterity is required to manipulate objects with fingers rather than whole hands (s) or arms.
- Communication skills using the spoken word.
- Hearing within normal range
- Seeing - within normal parameters
Equipment Used:
- Computer (Intermediate Level)
- Appropriate Office Equipment
- Ability to see within normal parameters.
- Ability to hear within normal range.
The Arc of Anchorage is an Equal Employment Opportunity Employer