Remote Optum Medical Coding Jobs in Massachusetts

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need.  The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way. Join us today and live our values: lead with heart, cultivate trust, go beyond.

Reporting to the Director of Healthcare Revenue Cycle Management, the Billing Specialist will handle all functions related to the collection of necessary claim documentation, claim submission, collections, and follow through on outstanding claims and cash applications. This individual will process all transactions relating to delinquent accounts, special adjustments, and/or write-offs, ensuring a smooth and accurate billing process. This individual will also lead regular cross functional meetings regarding consumer liability accounts, resolving billing and payment issues as needed.

• Gather all information necessary to process consumer insurance claims; ensure billing accounts, patient demographic and insurance information are set up and entered accurately
• Prepare and analyze reports, ensuring billing deadlines are met; identify root causes of the claims not being paid on time
• Lead meetings with cross-functional teams regarding consumer liability accounts; resolve billing and payment issues as needed
• Monitor, track, and report on self-pay balances using the billing system; identify issues, and recommend necessary actions
• Post 835 payment files to the billing system and edit any unmatched payments to post
• Research and resolve billing discrepancies; resubmit rejected and denied claims if necessary, working with payers to resolve outstanding claims issues as needed
• Audit file submissions and work through any variances, collaborate with management team as needed
• Perform other duties as assigned

• 3-5 years in medical billing field; Knowledge/experience working with billing and payment cycles for medical accounts and analyzing accounts receivable reports is strongly desired
• Strong data entry skills required; must possess exceptional attention to detail and prioritization skills
• Working knowledge of insurance processes and terminology, including an understanding of EOBs, copays, coinsurance, deductibles, spenddowns, denial codes, and cost shares
• Experience working with Medicaid, private insurance, insurance verification, authorization and reimbursement preferred
• Strong organizational, communication and analytical skills
• Proficient in MS Office (particularly Excel) and medical billing software, with ability to work across multiple spreadsheets and systems
• Ability to multi-task in a changing and fast paced environment

At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you: https://careforth.com/careers/#benefits

The pay range for this position is $40,560 - $56,784 OR 19.50 - 27.30/hr.

The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location.

#LI-Remote (Role is remote; however, we are unable to hire candidates residing in California)

Founded in Boston, Careforth\'s caregiver programs and services improve health outcomes, keeping care at home longer. Additionally, our programs provide financial benefit to caregivers and cost savings to state agencies and health plans. At Careforth, we understand the challenges of caregiving and are committed to supporting family caregivers at every turn.

Caregivers play a critical role in the future of healthcare—and so can you.

Apply now!

For more information, please visit www.Careforth.com.

Careforth is an Equal Opportunity Employer*

DISCLAIMER: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

*Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law.

Careforth strives to create experiences that are accessible and welcoming to everyone, including making www.careforth.com and the careers site accessible to any and all users. If you would like to contact us regarding the company’s diversity, equity and inclusion initiatives, inquire about a specific accessibility need or the accessibility of our website, or if you need assistance completing an application process, please contact People & Culture at 866-797-2333.