Responsibilities:
Processes billing to patients and third-party insurance companies
Receives, reviews, corrects, and enters claim information into the billing system.
Complies with HIPAA and other regulations and requirements.
Promptly resolves issues related to claim denials.
Performs all responsibilities to meet timely filing and other time-sensitive requirements.
Maintains required files of all appropriate documents and information.
Works at least 85 tasks daily.
Review patient eligibility and perks verification for treatments and procedures.
Coordinates with management and escalates and resolves billing issues.
Keeps up to date with healthcare practices, laws, and regulations related to insurance requirements and recent coding rules.
Corrects and resubmits claims for payers that require case rate code corrections.
Prioritizes work and manages time effectively to meet set requirements made by the manager.
Assists with other administrative tasks as needed.
Other duties may be assigned
Required Skills:
Minimum of 3 years experience in medical billing or collections.
Knowledge of medical terminology, CPT codes, ICD10, HCPCS, HCFA 1500 claim form, and HIPAA regulations.
Knowledge of Medicare,
State Medicaid, and Commercial insurance product guideline billing requirements.
Computer Skills/Proficiency using EMR and other software programs such as MS Word, Excel, and online payer portals.
Ability to comprehend medical record documentation to review charges and place of service billed accurately.
Maintain high billing standards that adhere to current industry guidelines.
Must have valuable oral communication skills and communicate effectively on the phone and in person.
Must be willing to adapt or adjust to accommodate the inflow of tasks and projects.
Must be extremely organized, highly motivated self-starter with excellent attention to detail.
Demonstrates initiative, ability to work independently and in a team setting.
Must be detail oriented to ensure all the details are done correctly the first time around.
Ability to multitask and navigate between platforms is a must.
Ability to act ethically and within the guidelines of company compliance policies and code of conduct.
Ability to meet daily productivity goals and other tasks and metrics as assignedssl