Medical Billing Specialist
1 week ago
JOB DESCRIPTION: Follows up on rejected claims and overdue patient and insurance balances using Explanation of Benefits forms and reports. Builds and maintains relationships with specified payors. Manages patient A/R, statement processing, and considers accounts for outside collections.
Responsibilities and Duties
Account Follow Up
Works with patients, following up on outstanding statements.
Using data from the monthly aged accounts receivable report, calls payors or looks up claims status online to inquire about unpaid insurance claims that are 45 days old; records response or activity in the computer system "notes"
Makes necessary arrangements for medical records requests, completion of additional paperwork, etc., if payors request this information prior to payment of claims
Uses payor policy manuals (often found online) to support completion of assigned tasks
Responds to written and telephone inquiries from insurance companies
Manages relationships with personnel from assigned carriers
Meets with Office Manager regularly to discuss and solve reimbursement and insurance follow up problems
Calls carriers to appeal payments that do not match contractual agreement; notifies Office Manager of payors for which this is a consistent problem
Asks physician to provide appeal language for denials or unacceptable payment
Processes requests for insurance refunds, and submits to Office Manager for approval
Responds to written and telephone inquiries from patients regarding their insurance questions
Claims Filing
Processes all paper and electronic claims for assigned carriers-verifies completeness of paper insurance claim information before mailing
Reviews edit reports from clearinghouse daily and resolves issues so claims can be processed
Follows up on rejected claims the day that the rejected EOB is received
Qualifications and Skills
Minimum eighteen months experience working in a physician group practice billing department
Familiar with CPT and ICD-10-CM coding for _orthopedic surgery, podiatric_ _surgery, and pain management procedures._
Familiarity with both facility (ASC/Hospital) billing and professional (Office) billing
Comfortable using email and interacting with Internet applications
Knowledge of practice management and word processing software
Able to establish good relationships with insurance companies
Good analytical skills and an affinity for detail
Ability to read and analyze accounts receivable and payor reports
Pleasant speaking voice and demeanor
Neat, professional appearance
Strong written and verbal communication skills
Accurate and fast data entry skills
Bilingual (Spanish) candidates preferred, but will consider others with solid experience
Experience:
Insurance Billing & Collections: 2 years (Required)
Patient Billing & Collections: 1 year (Required)
Ambulatory Surgical Center Billing & Collections: 2 years (Preferred)
Job Type: Full-time
Pay: $23.00 - $26.00 per hour
Benefits:
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
Experience:
Medical billing: 2 years (Preferred)
Language:
Spanish (Preferred)
Work Location: In person
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