Medical Claims Processor

5 days ago


Irving, Texas, United States PDS Health Full time
Medical Biller Job Description

At PDS Health, we're seeking a skilled Medical Biller to join our team. As a Medical Biller, you'll play a critical role in ensuring the accurate and timely processing of medical claims.

Key Responsibilities:
  • Process medical claims electronically, including auditing, tracing, and processing appeals for erroneous denials or inaccurate reimbursement.
  • Validate claims information to ensure compliance and reimbursement accuracy, correcting and resubmitting claims as needed if rejected by the Clearinghouse.
  • Act as a liaison between the Revenue Operations department and payers in resolving billing and reimbursement accuracy.
  • Process denials and prepare appeals with the appropriate documentation.
  • Monitor and maintain assigned account inventory, filing and following up on outstanding claims for timely reimbursement.
  • Collaborate with other departments and physician practices to ensure the accuracy of claims and ERAs/EOBs for posting of adjustments on accounts.
Requirements:
  • Equivalent to high school diploma or general education degree (GED).
  • At least 1 year of experience in hospital or physician billing.
  • PREFERRED: Epic and Relay experience, knowledge of Commercial payor, Medicare, and Medicaid rules.
What We Offer:
  • Medical, dental, and vision insurance.
  • Paid time off.
  • Tuition Reimbursement.
  • 401K.
  • Paid time to volunteer in your local community.

Pacific Dental Services is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.



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