Billing & Authorization Specialist at QRM (Quality Rehab Management) – Addison, Texas

QRM is seeking a Billing and Authorization Specialist focuses on obtaining Verification of Benefits and authorizations and or billing claims timely and following billing protocols for each client. For the billing role the duties include all collection follow up to endure timely collections for each claim. For the VOB and authorizations the duties include obtaining the information and communicating that to the client. The Billing and Authorization Specialist reports to the Billing and Authorization Manager. This is a hybrid position in our Addison, TX office (most weeks will consist of 3 in-office days - there may be occasions when more time in-office time is required)

Key Results Area

Learning AR and clearinghouse systems for each client

Billing all claims to appropriate insurance companies following each client’s SOP’s

Contacting insurance companies to obtain status of claims

Filing appeals and disputes with insurance companies to obtain correct payments.

Ability to handle large caseload of authorizations, billing and claims follow up daily/weekly

Enter all benefits verifications and authorizations into the proper system

Work within insurance company portals

Communicate findings to the clients in a timely manner Follow up on outstanding issues in a timely manner

Ability to work complex aging reports

Provides excellent customer service and human relations within the department as well as with other departments, providers, members and other external sources

Maintain patient confidentiality and information security

Assists with audits

Enters managed care authorization information into the rehab EMR

Evaluate and assess personal performance on a routine basis

Other duties as assigned

High school degree or equivalent

Microsoft Office proficiency, with the aptitude to learn new programs

Independent and self-motivated

Ability to provide information in a concise manner

Innovative and detail-oriented professional with strong analytical and organizational skills

Strong proactive written and verbal communication supporting client satisfaction and retention

Solid collaborative skills with team and clients with the ability to work remotely and autonomously

Strong time management with a proven ability to meet deadlines

Function well in a fast-paced and at times stressful environment

Demonstrate discretion, sensitivity, and ability to maintain client confidentiality

Ability to establish and maintain positive relationships

Strong written and verbal communication supporting client satisfaction and retention

Experience in verifying benefits and obtaining prior authorizations Working Conditions

Works in well-lighted/ventilated office, and as indicated remotely in a professional environment

Must be able to remain in a stationary position and move about the work area intermittently throughout the workday

Ability to observe details at close range

Constantly operates a computer and other office equipment

Ability to communicate and exchange information and ideas so others will understand