Billing Representative

Equal Opportunity Employer/Disability/Veterans

The Billing Representative reviews ensures the timely and accurate posting of accounts receivables.


Duties and Responsibilities

• Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation.
• Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other fields on the CMS 1500.
• Submit professional appeals and re-determinations, with appropriate clinical documentation, to Commercial, Medicare, and Medicaid payers when necessary.
• Reviews and corrects all claims/charge denials and edits that are communicated via Brightree
• Responds to patient and third-party inquiries, researches and resolves complex claims and corrects errors.
• Recognize and resolve authorizations issues with insurance payers and third-party authorization companies
• Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations.
• May transfer secondary balances to appropriate financial class and provide documentation for processing the claims.
• Receive payments through various methods (cash, online payments etc.) and check for credibility.
• Helps post cash batches and checks to individual invoices
• Reconciles deposits and invoices posted
• Send reminders for payments and contact customers with balances or insurance issues
• Update accounting records with new payments, balances, customer information etc.
• Answer questions and handle complaints from customers regarding bills
• Participates in accounts receivable projects
• Participate in standing meetings as necessary
• Perform other duties and special projects as assigned and directed

Basic Qualifications

• 18 years of age or older
• Must be eligible to work in the United States and not require work authorization from us now or in the future
• High School diploma or equivalent required; college preferred
• At least 1 year of experience in Medical Billing or relevant experience
• At least 1 year of experience with Brightree system

Required Skills

• Great customer service skills
• Professional computer experience (especially Microsoft Office Suite)
• Ability to work independently to investigate and make decisions
• Strong attention to detail
• Ability to prioritize and complete work amidst interruptions in a busy work area
• Adapt positively to changes in the work setting with ease
• Available during normal hours of operation
• Ability to comply with guidelines both internal and industry-imposed
• Working knowledge of third-party payor reimbursement
• Knowledge of medical billing, insurance rules and regulations required

Competencies

• Computer Skills
• Customer Service
• Ethics
• Organization Skills
• Productivity
• Results Driven

Work Environment & Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time.
• This role routinely uses standard office equipment such as computers, phones, and printers/scanners.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This job operates in a professional office environment.
• The noise level in the work environment is usually moderate to loud.

Direct Reports - None


Other Duties - Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.


Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.