Job Description Medical Biller - Physician Billing/Collections specialty
6 - month contract to start high potential for conversion
100% REMOTE, work from home (equipment will be provided)
Must have skills & experience:
At least 1 years of Physician Billing/Collections experience
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
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.
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Knowledge of accounting and bookkeeping procedures Knowledge of medical terminology likely to be encountered in medical claims
Follow up of outstanding A/R all payers and/or including self pay and/or including resolution of denials.
This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.
Responsible for working EDI transactions and ERA files, including reconciling carrier submissions, edits and rejection reports.
Ability to research and resolve accounts appearing on Delinquent Insurance Report, Collection Ledger and Government Payor report as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement.
Obtain referrals and pre-authorizations as required for procedures
Check eligibility and benefit verification
Review patient bills for accuracy and completeness and obtain any missing information
Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
Follow up on unpaid claims within standard billing cycle timeframe
Check each insurance payment for accuracy and compliance with contract discount
Call insurance companies regarding any discrepancy in payments if necessary
Identify and bill secondary or tertiary insurances
All accounts are to be reviewed for insurance or patient follow-up
Research and appeal denied claims
Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
Set up patient payment plans and work collection accounts Update billing software with rate changes Updates cash spreadsheet, runs collection reports