Medical Billing Team Lead | US HMO | Get a 21K Signing Bonus

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Medical Billing Specialist to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Account specific roles & responsibilities:

SNF Billing

• Process and submit claims for Skilled Nursing Facility (SNF) services.
• Bill Medicare Part A, Medicare Part B, Medicaid, Managed Care, HMO, and commercial insurance.
• Review patient census, admission, discharge, and payer information for billing accuracy.
• Verify patient eligibility, insurance coverage, authorizations, and benefit periods.
• Ensure compliance with Medicare SNF billing regulations and CMS guidelines.
• Monitor consolidated billing requirements and identify excluded services when applicable.

HMO Billing

• Submit and manage HMO claims according to payer-specific requirements.
• Verify referrals, prior authorizations, and eligibility.
• Resolve HMO claim edits, rejections, and denials.
• Ensure timely filing and comp