A medical biller is responsible for submitting medical claims to insurance companies and payers. It is a position that is critical for the financial cycle of all health care providers, from single-provider practices through large medical centers.
Medical billing requires attention to detail and experience with the electronic and paper systems used in billing healthcare services.
Physical Demands: Must be able to sit at a computer for extended periods of time, use files up to 40 inches in height and lift books and reports weighing up to 15 pounds.
- Obtaining referrals and pre-authorizations as required for procedures
- Entering patient demographic information such as name, address, date of birth, update provider information and insurance information to create office encounters for various practices
- Checking eligibility and benefits verification for treatments, hospitalizations and procedures
- Reviewing claims for accuracy and completeness, 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 timeframe
- Checking each insurance reimbursement for accuracy and compliance with contract discount
- Calling insurance companies regarding any discrepancy in payments if necessary
- Identifying and billing secondary or tertiary insurance
- Reviewing accounts for insurance or patient follow-up
- Researching and appealing denied claims
- Answering all patient or insurance telephone inquiries pertaining to claims billed
- Setting up patient payment plans and work collection accounts
- Updating billing software with rate changes
- Utilizing problem-solving skills to research and resolve discrepancies, denials, appeals and collections
- Working well in a team environment.
- Knowledge of insurance plans including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
- Competent use of computer systems, software and 10 key calculators
- Familiarity with CPT 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
- Knowledge of accounting and bookkeeping procedures
- Knowledge of medical terminology and have experience in Medical Billing
- This is a full time 40hrs per week position
- Working Hours: 8am to 4.30pm
- At the completion of probationary period Medical/ dental and optical coverage is available
- Paid Vacation / Holidays
- 5 days working
Education and Experience:
- High school graduate