Job Type Full-time Description

Job Summary : Responsible for submitting claims, appeals, and following up on outstanding balances from the patients insurance.

Essential Duties and Responsibilities : The essential duties of the position include the following. Other duties may be assigned.

Key Functions :

• Prepares and submit clean claims to various insurance companies either electronically or on paper.
• Contact carriers by phone or website for claim status on outstanding insurance balances.
• Process and work all insurance correspondence.
• Perform various collection actions including contacting patients by phone, correct and resubmitting claims to other carriers.
• Obtain necessary documentation required to submit to insurance to expedite payments.
• Answers questions from patients, clerical staff and insurance companies.
• Identify and resolve patient billing complaints.
• Prepare appeal letters for all claims that are denied for payment.
• Document all collection activities using guidelines in place.
• Identify underpayments by checking payments received against our contracted fee schedule.
• Work and process all insurance refund requests.
• Report payer issues or delays to supervisor.
• Participate in educational activities
• Maintains strict confidentiality; adhere to all HIPAA guidelines / regulations.
• Team Player with ability to solve problems and recommend solutions.
• Must be able to manage assigned workload and prioritize accordingly.
• Maintain accurate and timely reconciliation of accounts receivable.
• Review claims stopped in the claim scrubber.
• Work Claims rejected by the clearinghouse.

Requirements

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 ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education / Experience : High School Diploma or GED, and minimum one year experience in a medical billing / collections field.

Last updated : 2024-07-03