Billing Specialist, Revenue Cycle at VillageMD (Remote)

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Join VillageMD as a Billing Specialist working remotely ideally in Houston, TX

Join the frontlines of today's healthcare transformation

Why VillageMD?

At VillageMD, we're looking for a Billing Specialist to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies and support. Inspiring them with better practices and consistent results.

We're creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven and patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, and never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.

Could this be you?

The Billing Specialist plays a vital role to the success of the medical group.  The Billing Specialist will be responsible for reviewing all professional fee services performed in and out of the clinic setting.  This position is responsible for making sure insurance is eligible and all authorizations/referrals have been captured prior to dropping claims.  Additional responsibilities include validating coding for all assigned pre and post billing edits/rejections. To include validating correct CPT, Diagnosis, and Modifier usage for all assigned professional service claims.  Billing Specialist are expected to maintain no more than 2-day charge lag and produce 900 charge items per day.

While this role will be dynamic in nature, areas of responsibility are reviews information from patient’s medical record necessary to properly correct edits/denials associated with evaluation and management services, surgical procedures, supplies dispensed and/or administered in office or clinic setting, and diagnoses. Key responsibilities and expectations of the position also include:

How you can make a difference

  • Reviews information from patient’s medical record necessary to properly correct edits/denials associated with evaluation and management services, surgical procedures, supplies dispensed and/or administered in office or clinic setting, and diagnoses.
  • Inputs the appropriate codes/modifiers into the practice management system to rebill claims for proper payment.
  • Maintain communication with physician practice to facilitate denial and appeals review process.
  • Effectively utilize EMR system to review and validate coding as submitted on professional claims as assigned.
  • Communicate with nursing and ancillary services personnel for needed documentation for accurate coding.
  • Process pre-billing clinical edits within department timeframes.
  • Payor and patient accounts payment posting
  • Checking eligibility and benefits verification for treatments, hospitalizations, and procedures. Maintain knowledge of managed care carrier clinical documentation, coding, and billing guidelines.
  • Maintain knowledge of governmental payer clinical documentation, coding, and billing guidelines.
  • Complete annual CEU requirements as determined by governing body for any billing/coding certification designations.
  • Other duties as assigned.

Skills for success

  • Self-motivated: energetic, self-starter; can work autonomously with limited direction.
  • Results oriented: bias for action; demonstrated track record of achievement; drive for attainment of superior outcomes.
  • Flexible: ability to navigate within ambiguity; solution oriented.
  • Analytical: strong research, writing, analytical and critical reasoning skills.
  • Communication: conveys thoughts and expresses ideas effectively both verbally and in writing; strong presentation skills.
  • Collaboration: orientation to team-based work product and results.
  • Humility: low ego; engenders trust; respectful.

Experience to drive change

  • Minimum high school diploma or equivalent. Associate Degree Preferred.
  • Required Certified Professional Coder (CPC) or HFMA Certified Revenue Cycle Representative (CRCR) or other equivalent certification, or willing to obtain certification within 6 months of employment.
  • Three (3) years specialized training in coding and/or professional fee billing office.
  • Knowledge of anatomy, physiology, medical terminology, disease process, evaluation and treatment.
  • Three (3) years of ICD-10-CM, HCPCS and CPT-4 coding experience
  • A minimum of three (3) years’ experience working with a health care information systems/EMR ideally the Athena. Must demonstrate extensive knowledge of the current practice management software applications.

How you will thrive

In addition to competitive salaries, a 401k program with company match, bonus and a valuable health benefits package, VillageMD offers paid parental leave, pre-tax savings on commuter expenses, and generous paid time off. You work in a highly-collaborative, conscientious, forward-thinking environment that welcomes your experience and enables you to make a significant impact from Day 1.

Most importantly, you make a difference. You see a clear connection between your daily work on VillageMD products and services and the advancement of innovative solutions and improved quality of healthcare for providers and patients.

Our unique VillageMD culture – how inclusion and diversity make the difference

At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

Those seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.

Explore your future with VillageMD today.


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Candidate Location Eligibility:
Chicago, IL

Technology we use

  • Engineering
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • RLanguages
    • SqlLanguages
    • SwiftLanguages
    • ReactLibraries
    • FlaskFrameworks
    • Node.jsFrameworks
    • Microsoft SQL ServerDatabases
    • Neo4jDatabases
    • PostgreSQLDatabases
    • RedisDatabases
    • TeradataDatabases

An Insider's view of VillageMD

What's the biggest problem your team is solving?

Aggregating disparate sets into one consumable interface is difficult. We constantly think about how to solve it faster and better while keeping it flexible and scalable.

Mario

Principal Software Engineer

What makes someone successful on your team?

It’s an individual’s willingness to get into the details, fully understand the current path to delivery, and think critically about the problems that face providers today that will make them successful at VillageMD.

Dave

Director, Product Development

What’s the vibe like in the office?

The office vibe is centered on holding our work to high standards while maintaining an environment focused on fun and collaboration. My coworkers and I will often be working on completely unrelated projects, but when we hit a roadblock we step back and ask each other for feedback and help. That’s usually when we find the best solutions.

Emily

Healthcare Informatics Analyst

What are VillageMD Perks + Benefits

VillageMD Benefits Overview

We offer competitive bonus, great benefits, generous PTO, strong parental leave policy, and 401k with a match. We are conveniently located near Metra and L trains, and offer commuter benefits. We offer schedule flexibility and work from home options. And, last but certainly not least: loads of snacks and fresh ground whole bean coffee!

Culture
Volunteer in local community
Partners with Nonprofits
Eat lunch together
Intracompany committees
Daily sync
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Highly diverse management team
Unconscious bias training
Diversity manifesto
Mean gender pay gap below 10%
Diversity Employee Resource Groups
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
401(K) Matching
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
Flexible Work Schedule
Remote Work Program
Family Medical Leave
Vacation & Time Off Benefits
Generous PTO
Paid Volunteer Time
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Company Outings
Stocked Kitchen
Happy Hours
Recreational Clubs
Relocation Assistance
Professional Development Benefits
Job Training & Conferences
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Customized development tracks

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