Description
Pay Grade: H
Job Code: FIP070
Who we are. We protect lives.The Georgia Department of Public Health is the lead agency entrusted by the people of Georgia to proudly protect lives and promote healthy lifestyles in diverse communities statewide. We are committed to preventing disease, injury, and disability; promoting health and well-being; and preparing the State of Georgia for responding to disasters.
What we offer. As a member of the Georgia Department of Public Health team, you will join a passionate group of individuals who are dedicated to making an impact. No matter your role, you will individually contribute to protecting the lives of all Georgians while receiving a wide range of benefits, so you can:
- Make a Professional Impact – Build your career where it matters and protect lives in the community where you live, work, and play
- Enjoy Workplace Flexibility – Experience flexibility in how you work so you can be your best self for you and Georgia Residents
- Work with a Dynamic and Diverse Team– Collaborative and inclusive way of working where employees share ideas and leverage collective strengths
- Achieve Career Longevity – Countless opportunities for continuous learning/development that support a long-term career
- Take Part in a Hands-on Working Culture – Unique culture of active engagement and problem-solving, no matter your role
- Feel Pride in Where you Work – Be part of making an impact in public health alongside dedicated people just like you
The Northeast Health District seeks a Medical Insurance Billing Specialist to assist with the billing process. Primary responsibilities include working on medical claim denials by submitting reconsideration disputes and appeal letters by researching and submitting appropriate medical documentation and tracking appeal resolutions. Conduct root cause analysis for denials to ensure efficient claim processing. Assist and support clinic staff with respect to insurance.
As a Billing Specialist within the Northeast Health District at the Georgia Department of Public Health, you will join a dedicated group of public health professionals that help support the overall mission and vision of protecting lives of Georgian residents in a variety of ways.
Job Responsibilities
- Research payer denials related to referral, pre-authorization, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
- Independently write professional appeal letters.
- Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines.
- Submit retro-authorizations in accordance with payor requirements in response to authorization denials.
- Identify denial patterns and escalate to supervisor as appropriate with sufficient information for additional follow-up, and/or root cause resolution.
- Make recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials.
- Review payor communications, identifying risk for loss reimbursement related to medical policies and prior authorization requirements.
- Identify opportunities for process improvement and actively participate in process improvement initiatives.
- Review self-pay encounters for errors when billing should have occurred.
- Assist with insurance verification.
- Serve as backup to billing team members.
Minimum Qualifications
High school diploma/GED and one (1) year of job-related experience in accounting, billing, or budget services.
Preferred qualifications:
Medical billing experience, working with denials for Medicaid, Medicare and/or third-party payers. Medical Coding Certification (CPC).
Annual salary $36,000 plus generous benefits package including 13 paid holidays, annual and sick leave, health insurance, and retirement plans.
No phone calls, applications accepted ONLINE ONLY through the link posted.
Additional Information
The Georgia Department of Public Health commissioner and leaders encourage all employees to engage in regular activities and to make lifestyle choices that promote health and well-being.
The use of breaks during the workday is authorized to support this philosophy and assist employees in meeting their goals. A maximum of 30 minutes in a given workday may be used to engage in physical activities, generally in the form of two 15-minute breaks or one 30-minute break.
Employment Information
Current State employees are subject to State Personnel Board rules regarding salary.
DPH accepts educational credentials recognized by the Council for Higher Education Accreditation (CHEA) and/or the US Department of Education (DOE). DPH will contact educational institutions to verify degree, diploma, licensure, etc.
The candidate selected for this position may be subject to pre-employment drug screening and a criminal background check.
Relocation assistance is not provided.
As an employee of DPH, in the event of an identified emergency you may be required, as a term and condition of employment, to assist in meeting the emergency responsibilities of the department.
If you require accommodations under the American Disability Act (ADA), email you request to DPH-HR@dph.ga.gov by the closing date of this announcement.
DPH is an Equal Opportunity Employer
Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered but may not receive an interview. Selected applicants will be contacted by the hiring agency for next steps in the selection process. Applicants who are not selected will not receive notification.
This position is subject to close at any time once a satisfactory applicant pool has been identified.
