Offer summary

Qualifications:

Experience in medical billing and coding is preferred., Knowledge of third-party insurance processes and EOB interpretation is essential., Strong attention to detail and ability to meet production and quality standards., Excellent communication skills for customer service and team collaboration..

Key responsibilities:

Prepare and submit claims to insurance carriers, ensuring accuracy and compliance.

Follow up on unpaid claims and manage denial processes effectively.

Maintain confidentiality of customer information and adhere to company policies.

Collaborate with the Billing Manager to resolve reimbursement issues and improve billing processes.

Job description

Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.
Secures needed medical documentation required or requested by third party insurances.
Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers.
Responsible for consistently meeting production and quality assurance standards.
Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
Updates job knowledge by participating in company offered education opportunities.
Protects customer information by keeping all information confidential.
Processes miscellaneous paperwork.
Ability to work with high profile customers with difficult processes.
May regularly be asked to help with team projects.
Ensure all claims are submitted daily with a goal of zero errors.
Timely follow up on insurance claim status.
Reading and interpreting an EOB (Explanation of Benefits).
Respond to inquiries by insurance companies.
Denial Management.
Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.
Review late charge reports and file corrected claims or write off charges as per client policy.
Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy.
Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.

Business Support