Seeking a Medical Biller Responsible for Timely Submission of Technical or Professional Medical Claims to Insurance Companies.
Job Duties for Medical Biller
- Obtaining referrals and pre-authorizations as required for DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies).
- Checking eligibility and benefits verification for DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies)
- Reviewing patient bills for accuracy and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle time-frame.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Calling insurance companies regarding any discrepancy in payments if necessary
- Identifying and billing secondary or tertiary insurances.
- Reviewing accounts for insurance of patient follow-up.
- Researching and appealing denied claims.
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
- Setting up patient payment plans and work collection accounts.
Knowledge, Skills, and Abilities
Proficiency in the following areas is preferred:
- Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid and other payer requirements.
- Competent use of computer systems, EMR software
- Familiarity with HCPC and ICD-10 Coding.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
- Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. A calm manner and patience working with either patients or insurers during this process.
- Knowledge of medical terminology likely to be encountered in medical claims.
- Ability to multitask.
- A high school diploma
- A minimum of two years of experience in a medical office setting.