Description: The Medical Biller will accurately perform billing to third party payors and other related activities. These positions will work under the supervision of the Revenue Cycle Senior Manager. These positions will be responsible for generating CMS1500 forms and managing assigned patient accounts from receipt of insurance billing through submission of health care claim form to third parties. Other related duties that are needed to meet necessary daily work requirements or as assigned.
ESSENTIAL DUTIES AND RESPONSIBILITIES
· Prepares and submits clean claims to various insurance companies either electronically or by paper.
· Answers questions from patients, clerical staff and insurance companies.
· Identifies and resolves patient billing complaints.
· Prepares, reviews and sends patient statements
· Evaluates patient’s financial status and establishes budget payment plans.
· Follows and reports status of delinquent accounts.
· Reviews accounts for possible assignment and makes recommendations to the department leader.
· Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
· Maintains strictest confidentiality; adheres to all HIPAA guidelines / regulations.
· Participates in educational activities and attends monthly staff meetings.
· Performs all other duties as assigned.
Requirements:
· Minimum 2 years experience in medical billing as well as a strong knowledge of applicable laws and regulations. Some experience with insurance collections a plus.
· Proven track record in delivering and providing best in class customer service: delights customers above and beyond the call of duty; achieves excellent customer service ratings; shows empathy for the customers situation; gains an intimate understanding of customers needs; and works on building long-term relationships with customers.
· Ability to maintain a high level of integrity and confidentiality / patient privacy (HIPAA) with all information and communications.
· Ability to read, interpret and ensure compliance with insurance contracts, agreements and guidelines.
· Excellent time management and prioritization skills for handling high work volume, phone calls, and related administrative work.
· Demonstrated ability to communicate clearly with patients, caregivers, medical professionals, payers, and team members.
· Superior troubleshooting and problem solving skills.
· Ability to work accurately and has an eye for detail.
· Intermediate working knowledge of Word and Outlook. Experience working with billing, collections, or other insurance related systems helpful.
· Knowledge of diabetes and experience working in a medical device company preferred.
· Bachelor’s degree from a four-year college or university preferred. A high school diploma or general education degree required.
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