Medical Billing Manager

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    "requisitionDescription": "\n    <link href=\"https://static.workforcenow.adp.com/mas/mdf-components/24.23.14/styles/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\" />\n    <link href=\"https://static.workforcenow.adp.com/mas/mdf-components/24.23.14/styles/froala_style.min.css\" rel=\"stylesheet\" type=\"text/css\" />\n\n    <div class=\"fr-view\">\n      <div><div><div><link href=\"https://static.workforcenow.adp.com/mas/mdf-components/24.23.14/styles/froala_editor.pkgd.min.css\" rel=\"stylesheet\" type=\"text/css\">Here at Clinical Care Medical Centers, we are in need of a Billing Manager with i<span style='font-family:\"Tahoma\",sans-serif;'>n-depth knowledge of Procedural Coding, identifying appropriate ICD-10 coding based on CMS/HCC categories, CPT, HCPS CMS 1500 FORM, HEDIS, MRA, Super Bill, Electronic Claims Submission and Clearing House Operations, EOB and payments, denials and appeals, Billing, Collections and Appeals processes and Medicare and Medicare Advantage billing methodology and processes.&nbsp;</span><p><span style='font-family:\"Tahoma\",sans-serif;'><strong id=\"isPasted\"><span style='font-size:13px;font-family:\"Tahoma\",sans-serif;color:black;'>QUALIFICATIONS/EDUCATION:</span></strong></span></p><ul style=\"margin-left: 0.25in;\" id=\"isPasted\"><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Certified Professional Coder Certification&nbsp;</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Bi-lingual English/Spanish preferred; must be able to read, write and speak English.</span></li><li><span style='font-family:\"Tahoma\",sans-serif;'>3+<span style=\"color:black;\">&nbsp;years of experience in M</span>anaging a Medical Billing Department.</span></li><li><span style='font-family:\"Tahoma\",sans-serif;'>Moderate<span style=\"color:black;\">&nbsp;computer knowledge: MS Word and MS Excel, internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send e-faxes and email.</span></span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Strong people skills; independent decision making and customer service oriented. &nbsp;&nbsp;</span></li><li><span style='font-family:\"Tahoma\",sans-serif;'>Strong Organizational Skills&nbsp;</span></li><li><span style='font-family:\"Tahoma\",sans-serif;'>Credentialing experience, preferred.</span></li></ul><p><span style='font-family:\"Tahoma\",sans-serif;'><strong><span style='font-size:13px;font-family:\"Tahoma\",sans-serif;color:black;'><span style='font-family:\"Tahoma\",sans-serif;' id=\"isPasted\"><strong><span style='font-size:13px;font-family:\"Tahoma\",sans-serif;color:black;'>ESSENTIAL DUTIES AND RESPONSIBILITIES:</span></strong></span></span></strong></span></p><ul style=\"margin-left: 0.25in;\" id=\"isPasted\"><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Review medical records to identify if appropriate ICD-</span><span style='font-family:\"Tahoma\",sans-serif;'>10<span style=\"color:black;\">&nbsp;coding based on CMS/HCC categories is correct for billing purposes</span></span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Creat</span><span style='font-family:\"Tahoma\",sans-serif;'>e<span style=\"color:black;\">&nbsp;and submi</span>t<span style=\"color:black;\">&nbsp;insurance claims to different insurance companies</span></span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Process patients&rsquo; billing, statements, reimbursement claims, post transaction and data</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Proper documentation to different level of appeals base on insurance denials</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Communicating with insurance compliance for claim(s) payment/</span><span style='font-family:\"Tahoma\",sans-serif;'>rejections</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Submission of Doctor&rsquo;s application(s) for credentialing to insurance company(ies) as well as hospitals</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Collects patient payments with by mail or via telephone and ensure payments are properly recorded and processed</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Assist Practice Administrator in updating practice or Doctor&rsquo;s license(s)including but not limited to county, city and CLIA as well as distributing HEDIS/MRA reports to multiple providers</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Assist in the balancing of copays and Insurance payments for other service facilities</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Transmit Financial Report to Accountant</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Review A/R regularly and take the necessary collection action</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Ensure HEDIS</span><span style='font-family:\"Tahoma\",sans-serif;'>&nbsp;Claims Tracking and <span style=\"color:black;\">Reporting</span></span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Posting payments via ERA and manual posting of all Medicare, Medicaid and Third-Party Payers</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Review accounts for possible assignment and make recommendations to the practice administrator</span></li><li><span style='font-family:\"Tahoma\",sans-serif;color:black;'>Performs other duties as assigned.</span></li></ul><p><br></p><p style='margin:0in;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;' id=\"isPasted\"><span style=\"color:#767171;\">At Clinical Care Medical Centers, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by applicable law. Clinical Care Medical Centers believes that diversity and inclusion among our employees is critical to our success as a company. We support an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.</span></p></div></div></div>\n    </div>\n  \n",
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