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Medical Billing Specialist

3 months ago

Livermore, California, United States ICONMA Full time
  • This position is responsible for, but not limited to, the following:
  • Assures that all phases of processing client information are in compliance with HIPAA, PHI regulatory and related policies and practices; reports any Compliance issues to the Director of Operations.
  • Coordinates the insurance verification process and makes sure that the client understands their co-pay responsibility.
  • Responsible to follow-up as necessary to facilitate the collection of co-pays.
  • When applicable may gather credit card or other payment processing information from client and enters into system to process payment for account.
  • Manages the entry of client information into computer system in a timely manner and contact of referral source, customer and/or client to obtain missing information needed to set up client for service.
  • Ensures that the data is accurate and complete.
  • Confirms all sales orders in the system and ensures that all required information (e.g. proof of delivery, signed prescription, signed acknowledgement form, etc.) is on file before submitting claim for payment.
  • Follows up on all missing sales orders and reconciles billing questions on a regular basis until payment status is complete.
  • Responsible for the timely submission of claims (electronic and paper as needed) to payers; Corrects and resubmits front-end and back-end rejected claims. . Ensures that all cash is posted to the correct account in a timely manner.
  • Responsible for the timely follow-up and collection of payments due to the organization.
  • This is accomplished by generating invoices and/or following up with clients and/or payers.
  • Uses available resources to maintain current regulatory guidelines and reimbursement information to ensure that the company is obtaining all appropriate information as required for billing and reimbursement.
  • Performs other duties/projects as assigned by management including customer service support: processing, resolving and logging customer inquiries.