Medical Claims Coordinator/Processor
AVA Consulting
Medical Claims Biller
The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers. Review open/unpaid claim balances and take required action.
Major Duties & Responsibilities:
- Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
- Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
- Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.
- Determine if denied claims can be corrected and re-submitted to the carrier.
- Review aging reports to research open balances and resubmit within insurance carrier filing limits.
- Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
- Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
- Initiate overpayment refunds to patients and repayments to insurance carriers when required.
- Serve as the point of contact for the practice regarding all vision and medical claims.
- Support the corporate manager in maximizing claim collection rate.
Specific Skills Needed:
Medical Billing, cash application and collection (collection is not calling demanding payment; it's researching why a claim didn't get paid and taking steps necessary to correct the info) Years of Experience: 5 years
Basic Qualifications:
- High school diploma
- 3+ years of related work experience
- Experience with medical billing and coding
- Ability to prioritize handling of issues
- Organization skills and ability to multitask
- Effective communication skills (verbal, written, listening, presentation)
Preferred Qualifications:
- Experience working in multiple doctor practices
- Experience working with multiple insurance carriers and an understanding of their claim requirements
- Proven ability to identify issues and solve problems
Vacancy posted 3 days ago
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