Medical Claims Specialist

3 weeks ago

Grand Blanc, Michigan, United States Hart Medical Equipment Full time

Job Title: Medical Biller

Job Summary: We are seeking a highly organized and detail-oriented Medical Biller to join our team at Hart Medical Equipment. As a Medical Biller, you will be responsible for coordinating insurance and billing related activities associated with the care of our customers.

Key Responsibilities:

  • Enter charges accurately to ensure proper records handling and fast payment responses.
  • Initiate private pay collections after insurance cancellation, denial or other issue.
  • Follow up on unpaid claims within standard billing cycle timeframe.
  • Check each insurance payment for accuracy and compliance with contract discount.
  • Identify and bill secondary or tertiary insurances.
  • Maintain accuracy of tables as well as inform management with rate changes.
  • Address claims that remain unpaid and follow up with patients and insurance companies to determine the cause of the delay and to keep the billing cycle on track.
  • Look into claims that are denied and research how to modify the claim to ensure it is processed correctly at maximum reimbursement.
  • Answer inquiries made by patients, insurance companies, or fellow employees regarding assigned accounts, the billing process or the appeals process. This includes reviewing for accuracy, completeness, and obtaining missing information.
  • Maintain complete understanding and knowledge of all reimbursement requirements for assigned payer as well as general knowledge for payers outside of those assigned.
  • Communicate policy changes/issues to management so information can be communicated out to other areas of company.
  • Work with payers/provider representatives when necessary.
  • Uphold positive attitude towards tasks and co-workers, as well as a commitment to teamwork throughout the billing team and the organization.
  • Serve as troubleshooter for accounts receivable problems and as back-up troubleshooter for complete system.
  • Other duties as requested by Management.

Requirements:

  • High school diploma or general education degree (GED).
  • Minimum of six (6) months in medical insurance reimbursement and/or training; or equivalent combination of education and experience.

Skills and Abilities:

  • Excellent interpersonal, written and verbal communication skills.
  • Attention to detail.
  • Good data entry skills.
  • Proficiency with computers, with strong typing skills.
  • Good organization skills.

Language Skills: English (verbal, written)

Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure using a calculator.

Analytical and Problem Solving Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Certificates, Licenses, Registrations: None

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Environment: The work environment described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Office environment with moderate level noise.

Training: Orientation and selected courses must be completed in the designated time frame.

Additional Qualifications: None

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

By submitting an application, you are agreeing to the terms of Hart's Application Acknowledgement and Agreement found at https://hartmedical.org/application-agreement.

IRB Medical Equipment LLC, dba Hart Medical Equipment, is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, national origin, citizenship age, disability genetic information, height, weight, marital or veteran status or any other protected status in accordance with the requirements of applicable federal state and local laws. Hart Medical Equipment also provides reasonable accommodation for individuals with disabilities in accordance with applicable law.

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