Fertility Biller/AR Representative

Overview of Role: 2 Opening's - one more specifically focused on billing with alternative payers such as Progyny. The other role wil be more AR focused with a strong understanding of working claims, denials, appeals, and contacting insurance companies to reprocess claims.

The Patient Billing Representative will be assigned to work with a third-party contract and will be responsible for direct communication and coordination. While working with these alternative start-up payers can be complex, the core responsibilities remain standard billing functions, including:

• Day-to-day billing
• Claim review and denial follow-up
• Charge posting and payment posting
• Responding to patient billing inquiries

Additionally, the role involves working across multiple EMR systems depending on the site being supported.

Key Responsibilities:

• Complete patient billing procedures, including charge posting, payment posting, executing adjustments as appropriate, and managing special patient financial programs.
• Respond to patient inquiries regarding their accounts, research self-pay and insurance account activity, and provide accurate responses and necessary actions.
• Conduct "Next-day" financial reviews, identify outstanding patient balances, and attempt to collect payments, ensuring all efforts are recorded in the practice management system.
• Review EMR to ensure all services rendered and diagnoses are properly coded.
• Review, correct, and submit billing claims to the patient's insurance provider.
• Assist inter-company customers with questions regarding insurance matters, current account status, and billing inquiries.
• Communicate with third-party contract partners and navigate the complexities of alternative payer systems.
• Other duties as assigned.

Must-Have Skills & Qualifications:

• Strong medical billing experience (1+ year required)
• Previous experience in reproductive medicine or women's health preferred
• Prior experience with Athena preferred
• Knowledge of insurance liaison work, claims processing, account status management, A/R, A/P, and coding
• Strong Excel experience
• Comfortable navigating multiple EMR systems
• Fertility payer experience required

Soft Skills & Attributes:

• Self-starter with the ability to work independently
• Intrinsic motivation and strong work ethic
• Detail-oriented with a high level of accuracy
• Flexibility and openness to change in a dynamic healthcare environment
• Strong customer service skills with clear and empathetic communication

Benefits:

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

• Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

• Short Term Disability Insurance

• Term Life Insurance Plan

• Required Employment/ Compliance Language:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.