Full-Time Medical Biller

Duties and Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Productivity to process 60 – 70 accounts per day or as assigned the assigned task work queue
• Meets and maintains daily productivity/quality standards established in departmental policies
• Meets and maintains quality standards established in departmental policies
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team
• Knowledge of timely filing deadlines for each designated payer
• Initiate appeals when necessary
• Ability to identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Ability to analyze, identify and resolve issues causing payer payment delays
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Understanding of under payments and credit balance process
• Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team. Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Remote

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities:

• High school Diploma (Required)
• CPC (Preferred)·
• 2 years’ experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital
• Physician/Professional Billing: 1 year
• Knowledge of the denied claims and appeals process
• Knowledge of Worker’s Comp and PIP preferred
• Extensive knowledge of individual payor websites, including Navinet, Medicare, Medicaid, Availity
• Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
• Proficiency with MS Office. Must have basic Excel skillset
• Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred.