Medical Billing Specialist II - (St. Louis, MO)

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POST DATE 9/17/2016
END DATE 10/15/2016

QSI/NextGen Saint Louis, MO

Saint Louis, MO
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
High School Diploma or GED


NextGen Healthcare has a legacy of building software that improves patient care and reduces healthcare costs. Now, we re bringing the best of the cloud, social media and mobile to healthcare. Come build the future with us! Please visit our website at: .

Medical Billing Specialist II (St. Louis, MO)

Job Summary:

In this role as a Medical Collections Specialist you will perform medical billing and collection activities for assigned patient and insurance accounts. You will also develop and maintain effective working relationships with payers and/or clients as deemed necessary by your supervisor

Job Responsibilities:

* Review accounts to determine status and appropriate action required from workflow generated in the practice management system. Document follow-up appropriately in practice management system.

* Research and follow-up on denials and requests for additional information utilizing the denial management reports and correspondence

* Contact payers, use facility correspondence, via website, phone and/or correspondence, regarding reimbursement for unpaid accounts over thirty (30) days or as assigned

* Receive, review, research and respond to correspondence from insurance companies, attorneys and patients

* Work with other billing operations staff to enhance the collection process to ensure timely reimbursement on accounts

* Collaborate with management to identify payer trends and non-payment issues.

* Contact patients as needed to collect appropriate information or to collect patient balances.

* Identify, verify and document account adjustments according to established policy and procedure.

* Ensure service level and productivity requirements are met as it relates to reimbursement of accounts, resolution of tasks and response to inquiries, etc.

* Maintain positive working relationships with internal and external customers by providing superior customer service.

* Work accounts containing higher degree of complexity in claims and/or client mix requiring higher degree of investigation, communication and customer service skills.

* Utilize Medical and Billing Terminology.

* Adhere to Clean Claims Act and HIPAA policy and procedures

Required Qualifications:

* Three (3) plus years of billing/collections experience in a healthcare or insurance environment. College level education in Accounting, Finance, Medical Billing or Healthcare can be substituted on a year by year basis for experience.

* Experience where medical billing /collecting and standard office practices and procedure were necessary.

* High School Diploma or GED Certificate

* Knowledge of accounting and math skills.

* Knowledge of Medical and Billing Terminology.

* Intermediate knowledge of Excel and Windows based programs.

* Ability to work independently as well as in a cross-functional team environment by collaborating with others and sharing skills and knowledge.

* Strong problem-solving and analysis skills that demonstrate resourcefulness and initiative.

Desired Qualifications:

* Experience working with practice management software is preferred.

* Experience working in accounting or a financial institution

* Experience with ICD-9 and CPT coding.

* Experience working with NextGen software is preferred

* Knowledge of healthcare carriers and payer requirements

* Bachelor s degree in Finance, Accounting or healthcare related field

NextGen Healthcare believes in strength through diversity. We are an equal opportunity workplace and an affirmative action employer supporting Diversity, Disabled, and Protected Veterans. Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, gender identity, disability or veteran status.

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Because NextGen Healthcare believes in providing a safe work environment, we conduct background checks as part of our hiring processes.