Billing Specialist I

1 month ago

Dubai, Dubai, United Arab Emirates Energy Jobline Full time
{"title": "Billing Specialist I", "description": "Job Summary

We are seeking a highly organized and detail-oriented Billing Specialist I to join our team at Energy Jobline. In this role, you will be responsible for initiating prior authorization submissions and completing follow-ups for all insurance payors, including Medicare Advantage, Medicaid, HMO, PPO, and Commercial.

Key Responsibilities
  • Initiate prior authorization submissions and complete follow-ups for all insurance payors.
  • Compile pre-certification information to submit prior authorization requests via outbound phone calls and/or web-based sites.
  • Perform regular follow-up calls with insurance companies to check the status of prior authorization requests and log approvals in the database.
  • Conduct outbound and/or inbound calls to patients, doctor's offices, and insurance companies as necessary or required to complete tasks.
  • Ensure proper documentation is received and recorded before processing additional supplies to patients, per compliance guidelines.
  • Ensure accurate entry and update of changes as requested by physicians and/or patients.
  • Maintain a working knowledge of billing guidelines and resources for Medicare and Private Insurances.
  • Recognize and review billed orders to effectively request authorization for upcoming refills.
  • Research, follow up, and resolve all open/pending authorizations in a timely manner.
  • Develop and maintain knowledge of all products and services offered by the company.
  • Comply with HIPAA rules, appropriately safeguarding PHI or other private and confidential information.
  • Maintain accurate and detailed notes in the company's system.
  • Adapt quickly to frequent process changes and improvements.
  • Be reliable, engaged, and provide feedback to improve processes and policies.
  • Attend all department, team, and company meetings as required.
  • Route incoming calls when necessary.
  • Meet patient service quality standards.
  • Embody and exemplify ADS core values:
  • We grow together
  • We care
  • We obsess over the customer experience
  • We commit
  • We WOW
  • May perform any additional responsibilities or special projects as required.
  • Duties and responsibilities may be subject to change based upon the needs of the department.
Requirements
  • High School diploma or equivalent
  • Knowledge of insurance verification and/or authorization, billing, and processing claims
  • Basic knowledge of billing guidelines and resources for Medicare and Private insurance
  • Basic knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices
  • Proficiency in basic math and business calculations
  • Working knowledge of computer/data entry with the ability to learn new systems
  • Basic level of MS Office proficiency
Expected Competencies
  • Friendly, professional, and effective communication skills; able to calmly present solutions in challenging situations
  • Ability to work well in a team environment that promotes inclusiveness and communication among team members
  • Effective interpersonal skills
  • Clear diction and knowledge of the English language, both written and verbal
  • Detail-oriented, highly organized; able to work at a fast, productive pace
  • Service- and aptitude to resolve insurance and/or patient matters
  • Self-directed accountability and reliability
  • Cultural competence
Physical Demands

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk, and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements
  • Candidates must successfully pass a background check.
  • Candidates must be able to provide proof of eligibility to work in the United States.

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