New

Medical Billing Specialist Level 1

TEKsystems
$18.00 - $19.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Tennessee, Knoxville
May 05, 2025
Description Patient Account Representative 1 Summary: This position participates in various functions including the review, correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or improperly paid insurance claims. This position is responsible for billing and follow-up functions for payors in all financial class categories. This positions also provides patient customer service and releases billing records to approved entities. This position responsible for the timely and accurate completion of assigned tasks to facilitate proper claim processing. Description: ON-SITE Shift: Monday-Friday 8am-4:30pm (first day will start at 9:00am) 1.Provides clerical and administrative support for the billing team. 2.Responsible for daily submission of primary, secondary, and tertiary claim billing via the clearinghouse, payor portals, and paper mailing. Reviews deficient claims (i.e. claim rejections) that are unable to be processed by the payor, makes corrections, and processes rebills as appropriate. 3.Responsible for identifying financial and medical records necessary to support claim filing for all payor types for primary, secondary, and tertiary claims. Obtains and releases relevant documents as appropriate to facilitate timely and accurate claim processing. 4.Demonstrates problem-solving and critical thinking skills in analyzing rejections and/or denials to determine root-cause and best course of action to resolve account issues. 5.Demonstrates knowledge and comprehension of State and Federal regulations, Medicare, TennCare, and other Third-Party Payor requirements, assuring departmental compliance. 6.Possesses a basic understanding of billing regulations, claim submission guidelines, payor policies, Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and payor-specific rejection and denial language; demonstrates the ability to interpret these relevant to determining proper steps needed to resolve accounts. 7.Demonstrates the ability to extract pertinent information from payor correspondence and documents this in the practice management system. 8.Demonstrates the ability to use registration system and payor websites to verify patient plan eligibility, coordination of benefits, and plan participation with the organization to ensure timely and accurate processing of accounts. 9.Retrospectively reviews registration information obtained by clinics impacting claim rejections and/or denials. In cases of incomplete or incorrect registration information, consults payor websites to obtain correct information. When necessary, contacts payors and/or patients via phone or mail to clarify deficient registration information. 12.Provides accurate explanation to patients with questions related to claims processing, plan benefits, and account balances via verbal and written communication. Act as a liaison between the patient, charge entry staff, and office staff in cases of patient dispute of charges billed. Demonstrates good judgment when handling financial discussions with patients, always maintaining a professional and confidential environment. 13.Accurately processes practice management system transactions related to resolution of open accounts including but not limited to adjustments, transfer of payments, and refunds. 14.Properly calculates and applies patient balance adjustments such as Self Pay Discounts and Good Faith Estimate Adjustments in accordance with departmental and organizational policies. 15. Must achieve or exceed minimum expected work quality and quantity metrics as defined by department leadership. Skill set and competency to perform job requirements will be evaluated during initial 90-day training period. Pay and Benefits The pay range for this position is $18.00 - $19.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Knoxville,TN. Application Deadline This position is anticipated to close on May 19, 2025. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.