Medical Claims Specialist

4 weeks ago


Newark, Delaware, United States ADEX Full time
Medical Biller

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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