Prior Authorization/ Billing specialist

1 month, 1 week ago
Full-time
Mid Level
Operations

Grace Community Care Inc. / Grace Community Care and Day Habilitation

A New Jersey human-services and disability-services provider offering community-based supports, occupational therapy, housing supports, individual support, education and training, and related services for adults with intellectual and developmental disabilities and other mental, physical, and emotional challenges.

Human services, disability services, day habilitation, community-based care

Description

  • Prepare and submit accurate insurance claims using DRG, CPT, ICD-9, ICD-10, and other ICD coding standards.
  • Review and verify medical records for completeness and accuracy before billing.
  • Manage accounts receivable by following up on unpaid claims and patient balances.
  • Use EMR and EHR systems to document billing information and update patient records.
  • Collaborate with medical staff to ensure services are documented with appropriate medical terminology.
  • Reconcile billing discrepancies and resolve claim denials to support timely reimbursement.
  • Maintain organized records of billing transactions, claims, and correspondence for audit purposes.
  • Stay current on changes in medical coding regulations and insurance policies to maintain compliance.

Requirements

  • Proven experience in medical billing, medical office administration, or a related role.
  • Strong knowledge of DRG, CPT coding, ICD-9, ICD-10, ICD coding, and medical terminology.
  • Familiarity with EMR and EHR systems used in healthcare settings.
  • Experience with medical records management and medical collection procedures.
  • Ability to interpret complex medical documentation accurately for coding purposes.
  • Excellent organizational skills with strong attention to detail.
  • Effective communication skills for working with healthcare providers, insurance companies, and patients.
  • Prior experience working with medical coding standards and insurance claim submissions is highly desirable.
  • Compensation of $18.96-$19.75 per hour.

Interested in this position?

Apply directly on the company website

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