Key Facts

Remote From:

Full time

English

Hard Skills

Accounts Receivable Claims And Litigation Management Medical Billing Communicating With Patients Software Documentation Payment Processing Insurance Follow-Up Microsoft Operating Systems Medical Billing CMS-1500 Forms Copayment Collection And Processing Medical Science Industry Trend Analysis Good Documentation Practices

Other Skills

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Microsoft Word
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Microsoft Excel
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Persistence
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Telephone Skills
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Detail Oriented
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Verbal Communication Skills
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Support Colleagues
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Problem Solving

Roles & Responsibilities

High school diploma or GED required.
Two years billing and/or collection experience (preferably in the IV field).
Post-secondary education in a medical discipline highly desired.
Technical proficiency: Windows, Word, and Excel; excellent communication skills; ability to work with diverse personalities and strong problem-solving with attention to detail.

Requirements:

Generate and submit claims to copay programs and third-party payers; monitor timely filing and follow up on paid or unpaid claims, including appeals.
Verify patient balances, take patient calls, collect payments, and prepare patient balance reports for clients.
Obtain billing information regularly across multiple software systems; track claims with missing or incomplete documentation (e.g., HCFA, EOB) and drive resolution.
Follow up on denials and partial payments; prepare write-off forms when bad debt is identified; document notes clearly in client software and communicate trends to management.

Job description

Generate claims for submissions to third-party payers (commercial and federal/state government sponsored programs). These claims result from products and services administered to patients from our customers. Perform duties and responsibilities daily to ensure completions of accounts.

Qualifications:

Pre-Employment Education and Experience: Minimum of a high school diploma or GED required. Post-Secondary education in a medical discipline highly desired. Two years billing and or collection experience necessary, preferably in the IV field.

Technical Skills: Knowledge of Windows, Word, and Excel highly desired.

Special Skills: Excellent telephone and communication skills essential. Ability to deal with a variety of personalities in a professional manner is mandatory. Ability to assimilate a large volume of knowledge, detail orientation and good follow-through skills are crucial. Ability to use logic as a problem-solving skill, and able to recognize trends to make decisions to improve business.

Duties and Responsibilities:

Generate monthly patient statements
Verify patient balances are accurate and correct
Take patient calls & patient payments
Prepare patient balance reports to submit to client
Obtain billing information on a daily or weekly basis (depending on the frequency of the data transfers) to generate claims from a multitude of different softwares.
Track claims that are pending due to missing or incomplete documentation (ie: HCFA, EOB, etc.).
Bill/submit claims to copay programs in a timely fashion and within the timely filing period.
Perform routine follow-up calls to copay programs to determine the status of claims that are not paid within the normal claim processing time frame for a payer.
Submit appeals in a timely manner to ensure proper payment on outstanding claims
Resolve partial payments and denials in a timely manner
Provide exceptional communication for reimbursement customers within Accounts Receivable
Identify issues and trends and communicate to management as needed
Document notes clearly, concisely, and timely in Client’s software
Prepare a write-off form with a description of the reason for the write-off when bad debt is identified and be able to assist others with write off questions and process.
Miscellaneous duties as assigned.