Specialist II, Medical Billing

About the position

The Specialist II, Medical Billing at Teladoc Health is responsible for ensuring the quality and efficiency of medical billing processes. This role involves data analysis, knowledge of insurance and billing regulations, and collaboration with Revenue Cycle Management leadership to meet billing productivity and quality metrics. The position focuses on insurance verification, claim processing, and resolving claims-related issues to support reimbursement and collections methodology.

Responsibilities
? Meet department production and quality standards
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? Meet project and assignment due dates and deadlines
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? Manage inbound calls from members/internal service partners related to claims adjudication issues
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? Research and resolve any open requests for insurance and/or member refunds
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? Escalate claim resolution to management when necessary
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? Review all patient information and postings prior to claims submission
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? Submit claims to insurance carriers
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? Analyze denials and outstanding claims to determine appropriate remediation actions
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? Follow up to see if claims are accepted or denied
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? Investigate rejected claims and perform denial resolution review
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? Verify insurance coverage and maintain accurate member eligibility status in the database
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? Help automate existing processes and learn new systems
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? Maintain the privacy and security of all confidential and protected health information
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? Perform other duties as assigned

Requirements
? Associate degree preferred, or equivalent industry experience
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? Minimum 2-3 years of medical billing experience
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? Demonstrated ability to accurately calculate figures and reconcile accounts
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? Demonstrated verbal, written and interpersonal skills, with an affinity for teamwork
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? Organizational, multi-tasking and time management skills, with excellent attention to details
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? Comfort and success working in a fast-paced environment with tight deadlines
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? Demonstrated ability to proactively identify and resolve issues
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? Experience with medical coding and billing systems

Nice-to-haves
? 1+ years of quality assurance and training experience preferred

Benefits
? Performance bonus eligibility
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? Health insurance
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? Dental insurance
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? Vision insurance
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? 401(k) plan
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? Paid time off
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? Flexible scheduling options

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