Medical Claims Specialist
2 weeks ago
Key Responsibilities:
- Perform daily download and reconciliation of claims from patient accounting system to electronic billing system.
- Transmit or release claims at a minimum daily.
- Work all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
- Ensure the patient's medical information is accurate and up to date.
- Prepare and submit billing data and medical claims to insurance companies.
- Prepare bills and invoices, and documenting amounts due for medical procedures and services.
- Review same day and 72-hour admission report to determine if accounts needed to be combined.
- Work all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
- Bill or re-bill as necessary.
- Appropriately document electronic billing system and/or patient accounting system.
- Ensure hospital is following all state and federal rules and regulations both billing and HIPAA.
- Assigned special projects will be completed within the time frames given.
- Handle all customer calls both internal and external in a professional, courteous, and timely manner.
- Attend training sessions.
Requirements:
- Associate degree in business, health care administration, accounting, or a relevant field, preferred.
- Medical billing and coding certificates, preferred.
- Minimum of 2 years of experience as a medical biller or similar role.
- Solid understanding of billing software and electronic medical records.
- Must have the ability to multitask and manage time effectively.
- Excellent written and verbal communication skills.
- Outstanding problem-solving and organizational abilities.
- Experience with MS Excel and MS Word.
About ADEX:
ADEX is a leading healthcare provider dedicated to delivering high-quality medical services to our patients. We are committed to excellence in patient care, and we are seeking a skilled Medical Biller to join our team.
Why Work at ADEX:
At ADEX, we offer a dynamic and supportive work environment that fosters growth and development. Our team is passionate about delivering exceptional patient care, and we are committed to making a positive impact in our community.
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