Full-Time Medical Biller

Job Scope and Major Responsibilities:

• Educating clients and their healthcare team on the components of their insurance coverage, including Medical and Prescription benefits.
• Research billing issues and contact insurance carriers to resolve claim issues
• Advocating for patients/clients in the prior authorization process, including denials and appeals.
• Manage time sensitive task completion on referral and prior authorization submissions
• Ability to interact professionally with not only internal matrix partners, but external contacts such as providers, insurance carriers, patients, and other stakeholders
• Assist in monitoring trends and escalate trends to supervisor to determine actions necessary to improve service outcomes
• Must have regular and predictable attendance and timely arrival at work Schedule
• Compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, as amended (“HIPAA”)

Required Qualifications:

• Bachelor’s degree, in lieu of degree, 5 years of experience in Member Services or Provider Services, or Claims
• Prior experience in Member/Provider Prior Authorization/Appeal Services preferred
• Knowledge of medical terminology
• Knowledge of 3rd party payors, healthcare insurance and the prior authorizations process.
• Prioritize appropriately, and manage multiple tasks and job responsibilities
• Exceptional writing, editing and proofreading skills
• Strong verbal and written communication skills
• Strong organizational, analytical and problem-solving skills
• High motivation and the ability to work independently
• Working knowledge of MS Word, Excel, and Outlook
• Ability to preserve confidentiality of protected health information (PHI)
• Possess and maintain professional demeanor and courteous attitude