Job Purpose
The Medical Billing Representative posts payments received from insurance companies, cash payments, and payment plans to the patient's accounts; enters adjustments, write-offs, and reconciles the patient’s accounts.
The Medical Billing Representative reviews claims for non- payment, posts the zero payment to the patient’s account and writes off the unpaid procedures and claims; resubmits claims with corrected codes, submits secondary claims, and mails statements for co-pays and balances due on the account.
The Billing Specialist works reports, processes refunds and check requests; does account clean up, and serves as a resource to the medical practices to help improve billing processes and accuracy. Calls resident physicians for confirmation.
Specific Duties and Responsibilities :
The following are the specific duties and responsibilities of the Medical Billing Representative:
- Post cash payments, primary & secondary insurance payments, and Payment Plans
- Appeal denied services to insurance agencies.
- Write-off unpaid claims
- Mail Secondary Claims
- Mail Statements for Co-pays and Patient Balances
- Clean-up accounts
- Process Insurance Refund Requests for an overpayment
- Process Check Refund Requests from Patients work weekly reports.
- Assists medical offices with any patient/insurance payment questions.
- Achieve departmental goals for accurately submitting both paper and electronic.
- Insurance claims for the previous day’s treatment
- Verify all demographic (spelling of names, date of birth, and the insurance carrier) information is correct.
- Correct insurance and demographic information if incorrect and resubmit a corrected claim within 95 days from DOS.
- Adheres to company, department, corporate, personnel and standard policies and Procedures.
- Attend all mandatory company in-services and staff development activities as scheduled.
- Adhere to company standards concerning conduct, dress, attendance, and Punctuality.
- Support company-wide quality/performance improvement goals and objectives
- Maintain confidentiality of company employees and patient information
- Perform other duties as assigned.
- Provide support as an Administrative Assistant
- Communicating with clients via phone and email
- Entering Data into the client system
- Submission of claims, EOBs, and other pertinent billing documents
- Resolve client and billing issues with client team.
- Accessing data points in client tools
- Modifying, emailing and faxing documents
Requirements
- Bachelor’s degree in business, health care administration, accounting or relevant field is recommended.
- A minimum of 1 year experience as a medical biller or similar role.
- Must have the ability to multitask and manage time effectively.
- Excellent written and verbal communication skills.
- Outstanding problem-solving and organizational abilities.
- Senior Level EP