Job Description

Job Summary:
Responsible for accurately applying PPO guidelines to medical bills through manual processes in a timely manner. This role involves communication with clients, internal teams, and PPO Application specialists to ensure adherence to billing procedures and policies.

Essential Job Functions:

Identify provider participation status when automated processes are inconclusive.
Apply PPO guidelines accurately to bills requiring manual intervention.
Communicate effectively via email or phone with clients and internal teams:
Request bill images or documentation as needed for proper PPO discount application.
Address keying errors or discrepancies to ensure accurate billing.
Collaborate with the PPO Application team to resolve bill-related inquiries.
Utilize relevant software to calculate contracted rates, including AWP, Medicare, and state or federal fee schedules.
Assist Senior PPO Application Specialist in quality assurance processes when required.
Education:

High School Diploma required
Required Experience and Skills:

Prior experience in medical billing processes, including familiarity with CPT Codes, Revenue Codes, ICD-9/ICD-10 Codes, State Fee Schedules, UCR, and PPO.
Proficiency in Windows-based software/applications.
Strong typing accuracy skills.
Ability to review documentation and make decisions based on department policies.
Team-oriented with a proactive approach to work.
Equal Employment Opportunity:
We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Employment Type: Full-Time
Salary: $ 20.00 Per Hour

Job Tags

Hourly pay, Full time, Local area,

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