Insurance Billing Specialist

Mesa, AZ

Full Time

Experienced

Essential Therapy Solutions started in 2007 in response to the overwhelming number of families in our Arizona community requiring services. We obtained school contracts as well as becoming a Qualified Vendor with the Arizona Division of Developmental Disabilities (DDD). We also contracted with other agencies holding Arizona Early Intervention Program (AzEIP) contracts to deliver services to the birth to 3 population.

Our goal at Essential Therapy Solutions is simple - to be a leader in supporting families and providers in our community. We accomplish this by providing the highest quality services, information and resources to our families. Our goals are accomplished by the commitment of every employee.

ETS is an advocate for our families and providers by practicing the following values and beliefs:

Resourceful - We are proactive in networking within the community to educate our team.
Ethical - We are upstanding professionals that provide services by upholding our highest principles.
Acceptance - We are empathetic and honest providers who support our families.
Professional - We are responsible leaders that hold ourselves accountable.

SUMMARY OF RESPONSIBILITIES:

Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Ensures claim information is complete and accurate.
Obtain and input new authorizations into Raintree for billing purposes.
Maintain oversight of current authorizations and initiate requests for additional units as required.
Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
Address unpaid or rejected claims with insurance companies, resolving issues and resubmitting as necessary.
Craft and submit appeal letters to insurance providers for denied claims, gathering all necessary supporting documentation.
When accounts are past due, collaborate with clients to create payment plans that align with provider policies.
Manages the posting of insurance and patient payments within the Raintree system.
Follows HIPAA guidelines in handling patient information.
Confirm patient benefits and eligibility for coverage.
Discuss benefits and payment options with clients/families.
Able to utilize online resources or traditional coding references to research ICD-10 diagnoses and CPT treatment codes.
As needed, request waivers for AzEIP and DDD clients.
Collaborate with RCM and ETS Administrative teams
Attend all required meetings, bringing necessary data and information.

REQUIRED EDUCATION/EXPERIENCE:

Medical Billing Certification preferred but not required
Minimum 3 years of experience in medical billing
Experience of medical insurance/healthcare billing and collections work in a health system or medical practice
Thorough knowledge and working experience of CPT and ICD10 codes, HCFA 1500, medical terminology, appeal process, billing and insurance regulations and insurance benefits.
Ability to effectively deal with customers and secure payment, as well as to be able to discuss the finances of patients.
Exercises good judgment and discretion.
Familiarity with HIPAA privacy requirements for patient information. Maintains and protects confidential information.
Proficient in use of Word, Excel, other Microsoft Office tools and Google Workspace
Good verbal and written communication skills.
Good telephone and patient relation skills.
Detail oriented and ability to prioritize work.

BENEFITS

PTO
Medical, Dental and Vision offered.
Simple IRA with company match up to 3%
Hybrid - remote/in office schedule
Life Insurance of $50k per employee (can opt to increase this for a minimal employee cost)
Long Term Disability

SALARY

Hourly - $22-25/hr

We are an agency of providers dedicated to empowering families and their loved ones by enhancing their quality of life within our local communities. We foster creativity, growth and the wellbeing of our team members. By embracing inclusion, we foster a collaborative environment where everyone can flourish and thrive.

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Insurance Billing Specialist

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