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Medical Biller

2 months ago

Boston, United States Complete Staffing Solutions Full time $24 - $25
Job DescriptionJob Description

Responsibilities of Commercial Health Biller: Remote Must live in Mass 

  • Initiate appropriate electronic billings to commercial insurance, Medicare Advantage and MassHealth MCOs per coverage and limitations.
  • Responsible for claim follow up, Zero pays and the health bucket.
  • Work with various staff to investigate and correct problems according to established procedures.
  • Work with commercial insurance companies, MCOs and Medicare Advantage plans to identify status of accounts and obtain rapid resolution.
  • Resolve all denials and initiate appropriate appeals
  • Research customer complaints regarding accounts.
  • Access online EOBs and accurately research claims.
  • Use various systems to communicate, track, present and share information.

Qualifications of Commercial Health Biller:

  • Minimum of one year of experience as a patient account representative in a hospital or medical office setting.
  • Excellent interpersonal skills and strong team player.
  • Knowledge of commercial payers (BCBS, Tufts, HPHC) billing requirements
  • Knowledge of MCOs billing requirements
  • Experience using Waystar or related clearinghouse software a big plus
  • Must understand various payor EOBs.
  • Extensive track record of insurance company phone interactions to resolve billing and/or EOB questions.
  • Thorough experience with multiple payor online system access
  • Moderate to expert computer skills.