Key skills
Time Management
About this role
Role Overview
- Ensure a smooth, efficient, and timely claim submission process with minimal denials, including identifying gaps in claims
- Follow up on unpaid claims, denials, and appeals to ensure maximum reimbursement
- Investigate and resolve billing discrepancies or coding issues
- Collaborate with internal teams, including clinicians, to provide charting requirements and necessary documentation for claims submission, training team members on billing processes, and creating workflows for billing operations
- Provide support and guidance to patients regarding their insurance coverage, financial assistance, and billing inquiries
- Manage abortion fund invoicing and reimbursements
- Maintain accurate and organized billing records and documentation
- Generate and analyze reports to monitor billing performance and identify areas for improvement
- Support new payor partnerships, working collaboratively with internal and external stakeholders to own billing and coding workflows as we grow
- Maintain knowledge of current billing and coding regulations and updates
- Stay up-to-date with changes in insurance policies, fee schedules, and reimbursement rates
- Assist with other billing-related tasks as needed
Requirements
- 1+ years experience as a Billing Specialist in a healthcare setting (preferably in a telehealth setting)
- Deep expertise in Medicaid and Medi-Cal billing guidelines, including familiarity with state-specific reimbursement rules and eligibility verification
- Strong proficiency in ICD-10, CPT, and HCPCS coding, particularly as they relate to abortion services and sexual and reproductive health
- Proven experience managing the full claims lifecycle, including submission, denial management, and appeals
- Hands-on experience with Electronic Health Records (EHR) and Revenue Cycle Management (RCM) systems
- Solid understanding of HIPAA regulations and a strict commitment to maintaining patient data privacy
- Strong attention to detail and accuracy
- Ability to effectively communicate with patients, insurance companies, and internal stakeholders
- Proficient in using Excel or Google Sheets
- Ability to work independently in a fast-paced environment
- Strong organizational and time management skills
- Passion for advancing equitable healthcare, with a deep-rooted ability to empathize with Hey Jane patients
Benefits
- Unlimited vacation
- Health, dental, and vision insurance with FSA