Developmental Pathways is seeking an experienced Medical Biller with experience in ABA services to work in our administrative office. The ideal candidate will have a strong background in medical billing, with the skills necessary to improve our current billing procedures and reduce A/R days. The successful applicant will work on a number of tasks requiring data analysis, in-depth evaluation and exercising judgement within the appropriate scope of practice. We offer excellent benefits, generous paid time off and competitive compensation.

Responsibilities:

• Audits and corrects all claims on UB04 and/or CMS 1500 format.
• Review all EOB’s received in the mail that require attention.
• Complete data entry of all patient demographics, guarantor, and insurance information.
• Post procedures and insurance.
• Manage relationships with various Insurance payers.
• Call insurance companies to resolve billing issues.
• Call for Verification of Benefits.
• File claims to ensure maximum entitled reimbursement.
• Follow orders of detailed work activity.
• Ensure all claims are submitted with a goal of zero errors.
• Verify completeness and accuracy of all claims prior to submission.
• Meet all deadlines given.
• Read and interpret insurance explanation of benefits.
• Respond to inquiries from insurance companies, patients, and providers.
• Regularly meet with Financial Manager to discuss and resolve reimbursement issues or billing obstacles.
• Attend monthly staff meetings and continuing educational sessions as requested.
• Perform additional duties as requested by Director or Management team.
• Obtaining referrals and pre-authorizations as required for procedures.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Identifying and billing secondary or tertiary insurances.
• Researching and appealing denied claims.
• Setting up patient payment plans and work collection accounts.
• Updating billing software with rate changes.
• Updating cash spreadsheets and running collection reports.

Qualifications:

• High School Diploma/GED required.
• Minimum 2 years’ experience as a Medical Biller.
• Experience in ABA service codes required.
• Experience with NPA codemetro and Office Ally.
• Proficiency with electronic medical records (EMR)
• Strong knowledge of MS Access
• Ability to work independently and collaboratively within a team environment
• Able to multi-task and meet tight deadlines
• Excellent problem-solving skills

License:

• Driver's License (Required)

Typical start time:

• 9AM

Typical end time:

• 6PM

Pay Frequency:

• Bi weekly or Twice monthly

Pay:

• Hourly: $18 to $23 (upon knowledge and experience)

Schedule:

• Monday to Friday
• Day shift

Company's website:

• www.dpica.com

Work Remotely:

• No