Medical Biller/Collections Specialist

3 weeks ago


Melbourne, United States Robert Half Full time
Job DescriptionJob DescriptionWe are seeking a proactive and detail-oriented Medical Biller/Collections Specialist to join our healthcare team based in Melbourne, Florida. As a Medical Biller/Collections Specialist, your primary focus will be on collecting insurance data, processing insurance appeals, and maintaining accurate patient and insurance records. This role offers a contract to permanent employment opportunity.

Responsibilities:
• Accurately and efficiently collect insurance data from patients and physician practices to facilitate insurance claim submission
• Utilize insurance websites to settle unresolved insurance claims
• Maintain precise records in the finance system for generating insurance claims
• Handle all phases of insurance follow-up to secure insurance payment
• Exhibit strong phone skills for incoming/outgoing calls from patients, insurance companies, and customers regarding patient accounts
• Apply knowledge of CPT & diagnosis codes, LCD/ NCD, and payer medical policy guidelines
• Review and research denial reasons and implement corrective measures
• Retrieve and re-file documents required for audits or insurance requests
• Update incorrect patient addresses in the system after thorough research
• Prepare information & spreadsheets for attorney follow-up
• Perform additional duties as assigned.• Proficiency in Accounting Software Systems is a must for efficient management of financial records.
• Solid understanding of Accounts Receivable (AR) is required to handle pending payments and follow-ups effectively.
• Ability to manage Appeals is crucial to ensure proper resolution of discrepancies in billing.
• Experience with Authorizations is necessary to maintain regulatory compliance in the billing process.
• Knowledge of various Billing Functions is essential to perform the job role effectively.

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