Medical Billing Specialist

WellPower provides you with the support you need to help you develop a career in helping others succeed. We innovate, adapt, and leverage the diverse perspectives of the people on our team and the people we serve in everything we do.

WellPower values and is strengthened by diversity. We are committed to ending bias and discrimination in our community and ensuring equity within all aspects of our organization. We are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment, transfer, or promotion opportunities without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. 

As part of Accounts Receivable/Billing team, responsible for medical insurance billing, reporting and accounts receivable reconciliation functions, denial management, verifying and updating client insurance benefit information, tracking required client financial documentation, obtaining and tracking authorizations, consulting clients via phone to obtain information, explain benefits and explain and collect balances, coordinating insurance information with clinical sites. 90% remote position but must live in Colorado.   Must have experience verifying Medicaid, Medicare, and commercial insurance. CPB/CPC-A encouraged to apply.

Each Accounts Receivable Coordinator will specialize in at least two AR areas and cross-train in three or more of the above areas.

Learn more about WellPower:

STARTING SALARY: $25.69/hr - $26.44/hr

WellPower is committed to fair and equitable hiring with salaries based on relevant factors, such as work experience, education, and certification/licensure (rather than wage history). Toward the principle of equal pay for equal work, we post and hire within defined hiring salary ranges.  We ask all applicants to carefully review the hiring salary range for each posted job opportunity, as we will not hire outside the predetermined range.

All full-time, benefits eligible employees will be eligible for WellPower’s benefits plan. For a full description of benefit offerings, please visit: https://WellPower.org/workplace-of-choice/.

 ESSENTIAL JOB FUNCTIONS:

• Prepare and submit electronic and paper claims to Medicare, Medicaid and other Third-Party Payers in accordance with prescribed standards.
• Post receivables and reconcile AR accounts.
• Denial Management
• Maintain accurate billing records in accordance with prescribed standards.
• AR monthly reconciliation reports
• Obtain and maintain accurate, detailed client eligibility information in AR and client database system.
• Verify client eligibility and benefits.
• Track service authorization requirements and usage and obtain authorization as necessary.
• Cross trains in several functional areas or specific duties, processes, as assigned.
• Answer incoming calls from clients, clinicians and other staff members on the department’s Billing Line phone system.
• Maintain a trauma informed environment of wellbeing.
• Perform other duties as assigned.

Benefit Verifications:

• Obtain and maintain accurate, detailed client eligibility information in AR and client database system.
• Verify client eligibility and benefits.
• Assist clinicians in completion of necessary administrative paperwork related to insurance or a client’s financial information.
• Track required client financial documentation and assist clinical teams as needed in maintaining documentation in accordance with payer requirements.
• Explain benefits and financial responsibility to clients.  Obtain client insurance information as needed to determine ability to pay.
• Lab Corp Billing and benefit checks

Authorizations:

• Track service authorization requirements and usage and obtain authorization as necessary.
• Act as direct liaison to clinical teams, communicating about client information to obtain authorizations.

Billing:

• Prepare and submit electronic and paper claims to Medicare, Medicaid and other Third-Party Payers in accordance with prescribed standards.
• Communicate with AR Manager and AR team of any issues that interfere with claim submission/payment remittance.
• Post receivables and reconcile AR accounts.
• Maintain accurate billing records in accordance with prescribed standards.
• Prepare accurate AR reports as necessary.
• Work with AR Manager to research Medicare, Medicaid and Third-Party issues as needed.
• Follow through with other Programs/Departments to ensure accuracy and compliance with billing standards.
• Injection Billing and tracking
• Perform other duties as assigned.

Denial Management:

• Contact payers to resolve claims payment discrepancies.
• Research and handle claims payment appeals and denials.
• Work with AR Manager to research Medicare, Medicaid and Third-Party issues as needed.
• AR monthly reconciliation reports

EDUCATION:  Preferred associate degree in business, medical billing or related field, or equivalent experience in healthcare/medical insurance environment.

EXPERIENCE:  Minimum two years of healthcare financial/business office or similar third-party payer claims experience. Must have experience verifying Medicaid, Medicare, and commercial insurance. CPB/CPC-A encouraged to apply.

WORKING CONDITIONS:  Monday - Friday - 40 hours per week. May occasionally vary depending on business needs. This role is approx. 90% remote, with one in-office day per month. Candidates must reside in Colorado in order to be considered.

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