Medical Billing Specialist (Remote)

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a startup with a simple mission: Delivering extraordinary outcomes by unlocking the power of caregivers. Caregivers are one of the largest, most untapped resources in the healthcare delivery system and are the unsung heroes of their care recipients. Yet despite their vital role, they are largely unsupported and invisible to the healthcare ecosystem.

At Vesta Healthcare, we enable people with personal assistance to thrive at home, in their community by assuring the people they rely on, their caregivers, have the resources, data, and support they need.  We achieve this through a combination of analytics, technology, services, and deep healthcare expertise. Our analytics help identify and target the right people and populations. Our technology creates real-time connectivity and actionable data out of observations. Our services connect to real people who can help when needs arise, and our healthcare expertise helps us understand how we create value for both payers and providers.

Our program monitors in real-time, identifying issues before they become health events, and helping connect those in need with those who can help via technologies such as video, chat, and telephone. Our technology platform includes home-based mobile applications, a clinical dashboard, and data analytics on data not previously available to health professionals. We are disrupting a $109 billion industry and have recently closed our latest funding round with a blue-chip list of investors.

We’re looking to add to our team of experts who care deeply about our mission.  

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to transform our  healthcare system. We're inspired by caregivers and seek to create a platform that recognizes, utilizes and supports the vital role they play.  We strive to  continuously learn, explore, experiment and achieve results. We are here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids)

The ideal teammate would be…

An individual who’s passionate about people, data, and problem solving through collaboration. Our ideal candidate is detail- and people-oriented, dynamic, and will always go the extra mile to see our team be successful. They are proactive problem-solvers, motivated to seek out trends, self-driven, and like to collaborate cross-functionally to achieve shared goals. 

The ideal teammate would be able to:

• Manage and perform insurance verification, claims and denials submission, and the appeals process. 
• Including but not limited to claim rejections for demographic or payer errors, credentialing or EDI enrollment, or corrections that may be coding related for modifier or diagnosis pointer reassignment, etc.
• Member lifecycle support including but not limited to member demographic and insurance information collection, billing and financial statement review.
• Research and respond to routine customer billing and billing statement inquiries.
• Work all assigned accounts with established procedures until the account is paid in full by all primary, secondary, and tertiary payers, escalated, disputed, or finalized.
• Ensure claims are submitted and/or followed up with any required actions within payer timely requirements as specified by payer guidelines.
• Processes insurance correspondence to include validation of all remittance advice, explanation of benefits, appeals, denials, and/or other related documents.
• Able to analyze member insurance benefits to provide coinsurance estimates, if needed.
• Immediate and appropriate escalation of payor trends and issues to management which impact cash, aging reports, and processes.
• Work with management and cross-functional teams to promote and improve billing processes.
• Ensures professional verbal and written communication with internal and external customers following established guidelines.
• Adheres to HIPAA and Compliance Policy Guidelines at all times to ensure member and client confidentiality.
• Performs other duties as required for work similar, related, or is a logical assignment associated to the position.

Would you describe yourself as someone who has:

• Minimum of three (3) years’ experience in professional billing (required)    
• Working knowledge of Microsoft Office/G-Suite products (preferred)
• General medical coding experience, CPC Certification (preferred)
• Experience using an EMR system, eClinicalWorks (highly preferred)
• Experience using various eligibility platforms, such as Ability, Availity, etc.
• Working knowledge of insurance payer portals
• Strong written and verbal communication 
• The ability to collaborate effectively with multiple departments
• Strong problem solving skills; able to identify problems and escalate when appropriate
• Excellent organizational skills and ability to multitask 
• High achiever that can prioritize and produce results autonomously
• Ability to adapt to the use of multiple software platforms
• Comfort in a dynamic and always evolving startup environment

In addition to amazing teammates, we also offer:

• Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
• Paid vacation
• Paid Sick/personal days
• 12 paid holidays
• One time reimbursement to set up your home office
• Monthly reimbursement for internet or other home office expenses
• Monthly gym reimbursement to be used for gyms, online classes, etc
• Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
• Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
• Pre-tax Flex Spending/Dependent Care/Transit accounts
• 401k with match
  Pay range is $42K - $50K annually. (The referenced salary range is based on the Company's good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level).

We look forward to speaking to you!

Vesta Healthcare is committed to leveraging the talent of a diverse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.