Medical Billing Specialist-Full Time

Job Description

Are you a skilled medical billing professional looking for a new opportunity? Are you well-versed in payer requirements, billing regulations and navigating medical billing software systems? Consider Goodwill NNE! Here you can support the success of our Health Care Division and join a team dedicated to serving the community and each other.

Goodwill Northern New England — good works here!

• Medical, Dental, Life and Vision insurance offered
• 403(b) retirement plan
• Paid Short& Long Term Disability
• Generous Paid Time Off Plan
• Paid Holidays
• 30% Employee discount at Goodwill stores in ME, NH & VT
• Valuable job training with growth potential
• Discount on personal cell phone plans
• Local communitydiscounts

1) Responsible for the timely, accurate and maximum adjudication of charges for client services while providing the highest level of customer service. Duties include:

• Communicates with payers, clients, case managers, intake and other agency personnel.
• Ensures that denials are resolved accurately and within the payer specified time frames.
• Researches and resolves payment issues within the payer specified time frames.
• Responsible for meeting all weekly and monthly billing deadlines.
• Demonstrate ability to run and analyze claim and payment data.

2) Represents the Agency in all interactions with other members of the Goodwill community and with the general public, supporting the agency Vision of creating sustainable communities that thrive through the fullest participation of their diverse residents.

3) Furthers the organizational commitment to triple bottom line results: integrating social, economic and environmental goals into thinking, planning and actions.

• Communicates with payers, clients, case managers, intake and other agency personnel.
• Professional, effective and timely communication with payers.
• Ensures that denials are resolved accurately and within the payer specified time frames.
• Compiles production, client and other statistics reports as requested.

• Demonstrated ability to understand and utilize Medical Billing and Electronic Health Record program/systems.
• Demonstrated ability to access, utilize Molina, Medicare and Commercial payer online portals and websites.
• Researches and resolves payment issues within the payer specified time frames.
• Assists with data for cost reports, audits and other compliance requirements.
• Knowledge of MaineCare and Medicare billing systems.
• Knowledge of applicable rules and regulations including Mainecare and HIPAA.

• Produces accurate and timely billing and other documentation as required.
• Records payments in accordance with agency procedures.
• Applies and analyzes technical contractual knowledge of agreements and regulations to ensure appropriate eligibility and authorizations are maintained.
• Maintains billing and other related documentation in accordance with agency policies, procedures and deadlines.
• Completes reconciliations of clinical billing and related receivables.

Qualifications

• Minimum of 2 year medical/clinical or related billing experience with well-developed claims processing skills.
• Knowledge of MaineCare and Medicare billing systems.
• High school diploma or GED required.
• Demonstrated personal computer, word processing, and data entry skills; proficiency in a computerized accounting system; intermediate skills in MS Excel required; basic knowledge of MS Access; ability to work with Internet
• Knowledge of general office practices and procedures.
• Ability to maintain confidentiality of classified information.
• Ability to lift up to 20 lbs.
• Criminal background check that meets Agency standards.
• Adhere to all HIPAA rules.

• Associates degree or related certification.
• Experience with medical billing systems and/or software.

Additional Information

• All your information will be kept confidential according to EEO guidelines.