Amwell is a leading telehealth platform in the United States and globally, connecting and enabling providers, insurers, patients, and innovators to deliver greater access to more affordable, higher quality care. Amwell believes that digital care delivery will transform healthcare. We offer a single, comprehensive platform to support all telehealth needs from urgent to acute and post-acute care, as well as chronic care management and healthy living. With over a decade of experience, Amwell powers telehealth solutions for over 240 health systems comprised of 2,000 hospitals and 55 health plan partners with over 36,000 employers, covering over 150 million lives.
The Medical Billing Specialist is reporting to the Service Operations Manager, PMO. Amwell is seeking a motivated and energetic Medical Billing Specialist to join the Project Management Office (PMO) at Amwell within the Professional Services Department. The Medical Billing Specialist will play a critical role in clinical and financial operations, as a team player. Specifically, the Medical Billing Specialist will be responsible for assisting with the Amwell Medical Group claims and real time eligibility processes. Responsibilities include prospectively interfacing with clients, as well as internal Professional Services, and Technical Services teams. Additionally, the Medical Billing specialist will be responsible for overseeing the health plan claim activity within vendor owned systems. This includes but is not limited to assisting with claim life cycle tasks, and assisting with Electronic Data Interchange implementations. Most importantly, the Medical Billing Specialist will be responsible for subject matter feedback in order to assist with Medical Billing support.
- Serves as an expert in all aspects of the Amwell Medical Group Health Plan and Health System space. This includes, but is not limited to, Real Time Eligibility, Electronic Remittance Advice, Clinical Coding, Clinical Operations, and other Claim related fields.
- Serves as a check point for health plan Clearinghouse Vendor, in relation to clean claim submission. This includes, but is not limited to, a review of rejections, incomplete claims, claim edits, and fee schedules.
- Serves as a check point for health Plan Clearinghouse Vendor, in relation to claim remittance and posting. This includes, but is not limited to, a review of denials and/or appeals when necessary.
- Manages external Health Plan correspondence related to non standard claim information requests.
- Provides functional and technical guidance to the L2 Support team with respect to Real Time Eligibility, AMG Medical Billing, Clinical Coding, and Quality Assurance.
- Communicates and contributes to ongoing Medical billing assigned initiatives; uses sound judgement in assessing project health, identifying, mitigating, and resolving any project issues.
- Contributes to continuous process improvements related to Revenue Cycle Management within the Project Management Office and Professional Services organization.
- Minimum 3-4 years of experience working within a Medical Billing related field.
- Coding Certified – AAPC CPC Preferred
- Exceptional communication, team building, and people management skills. Proven ability to meet aggressive deadlines.
- Proven experience managing Medical Billing initiatives related to evolving and changing customer base.
- Experience with Microsoft Office products (e.g., Word, Excel, PowerPoint, Project, Visio), Salesforce and Atlassian products (e.g., Confluence, JIRA).
- Experience with Change Healthcare and/or Availity products (e.g., Lyra, Real Med, BPI).
- Proven ability to execute Medical Billing skillset effectively, as a way of combating visit revenue loss, and improving compliancy.
- Familiarity with CMS/AMA billing guidelines, as well as health plan revenue cycle.
- AA or AS degree or 3 years or more of work experience is required.
Working at Amwell
We strive to make the hard work of healthcare look easy. In order to make this a reality, we look for people with a fast-paced, mission-driven mentality. We’re a go-getter culture that prides itself on quality, efficiency, smarts, initiative, creative thinking, and a strong work ethic. Our corporate headquarters are located in downtown Boston at 75 State Street –in the heart of the city. In addition to the opportunity to build the future of healthcare technology and a great location, we offer:
- Unlimited Paid Time Off
- 401K match
- Competitive health, dental and vision insurance plans
- Pre-tax commuter benefits
- On-site gym – free to use and open 24/7
- Prime office space with roof deck access and views overlooking all of Boston
- Café lounge stocked with a wide range of complimentary snacks, coffee and other beverages.