Medical Biller

Must haves:

• Minimum three (3) years' experience years of related healthcare billing support experience.
• General knowledge of MS Office Suite (Outlook, Word and Excel).
• General knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms, and other office procedures and terminology
• Customer and Personal Service - General knowledge of principles and processes for providing customer and personal services. This includes needs assessment, meeting quality standards for services, and evaluation of user satisfaction

Responsibilities:

• Responds to inquiries and resolves discrepancies involving moderately complex financial transactions in a timely manner, requiring a general understanding of work-area policies and procedures.
• Reviews, follows up, and appeals for aged insurance balance accounts to ensure timely revenue collection through use of EDI clearinghouse, payer portals, worklog and reports for NextGen and/or Axium.
• Reviews and processes delinquent unpaid accounts by patients accounts eligible for collections.
• Processes referrals or authorizations as required by payers.
• Processes claims for multiple payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.).
• Ensures assigned claims meet clearinghouse and/or payer processing criteria.
• Ensures appropriate follow-up on assigned work lists.
• Ensures work meets departmental productivity and quality review standards.
• Communicates issues regarding claims follow-up process and potential resolutions.
• Works with payer response reports and rejection reports to meet Departmental Productivity and Quality Review Standards. Complies with federal, state, and company policies, procedures, and regulations.