The essential functions include, but are not limited to, the following:

• Claims creation and submission through applicable practice software

• Pre-submission reviews of authorizations and medical invoices ensuring correct codes, documentation, and necessary information are being provided to carriers

• Provides input on system edits, processes, policies, and billing procedures to ensure maximization of revenues

• Actively monitors documentation for errors and edits rejected claims for resubmission

• Runs daily and weekly reports for billing control purposes

• Ensures credibility of payments by validating accounts

• Follows up with payments to monitor and solve any discrepancies

• Resolves any client billing concerns and questions

• Prepares timely and accurate client invoices

• Processes voids and rebills for invoices as needed

• Ensures that work complies with operational policies and procedures, and regulatory requirements

• Participates in workgroups and meetings as well as attends all required training modules

• Reviews reports to identify revenue opportunities and unpaid claims

• Clears all emails and voicemails by EOD

Minimum Qualifications (Knowledge, Skills, and Abilities)

• Associates Degree

• 3 years' experience in medical billing is strongly preferred

• Experience using a practice management system and EHR (Electronic Health Record)

• Thorough understanding of CPT, ICD-10 and HCPCS coding

• Knowledge of commercial insurance plans and Medicare

• Ability to track assigned insurance claims

• Experience using daily denials management tools and reports