Performs accounts receivable functions including billing, pursuing reimbursement, customer service, and record keeping.
Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior to submission.
Follows up with insurance companies on unpaid or rejected claims. Resolves issues and resubmits claims.
Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations.
Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer issues in an effort to recover proper reimbursement.
Provides customer service relating to all billing inquiries and complaints. Able to explain insurance processes, benefits, and exclusions. Follows HIPAA guidelines in handling customer information.
Performs other billing duties as requested by the Billing Supervisor, Billing Manager, or Director of Billing.
Qualifications and Requirements:
Must have a high school diploma, college degree preferred, not required.
Six months to one year related experience and/or training; or equivalent combination of education and experience.
Proficient in use of computers and software including, but not limited to: practice management software, word processing and spreadsheet applications.
Detail oriented with ability to multi-task.
Manages one’s own time with minimal supervision.
Strong mathematics and problem solving skills.
Seeks and shares pertinent information related to insurance or internal processes.
Communicates effectively both verbally and in writing to convey and receive information.
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Self-evaluates performance to make improvements or take corrective action. Consider the relative costs and benefits of potential actions to choose the most appropriate one.
Use equipment, facilities, and materials appropriately as needed to do certain work.
Regularly required to sit, stand, walk, and occasionally bend and move about the facility.
Infrequent light physical effort required.
Occasional lifting under 10 lbs.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Work performed in an office environment.
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