Medical Biller

Medical Biller

Elevate Patient Financial Solutions has an exciting career opportunity available as a Medical Biller. This position will be located in our regional office in Glen Burnie, MD. The full-time schedule for this role will be Monday through Friday, 8 AM to 4:30 PM.

Job Scope

The Medical Biller is responsible for pursuing collection of all receivables from third-party and governmental payers.

Essential Duties and Responsibilities

• Continual follow-up on outstanding accounts through contracts/inquiries to third-party and governmental payers to facilitate prompt resolution or payment based on the Follow-Up department guidelines.
• Sort, prioritize, document receipt of insurance/patient correspondence, respond by initiating appropriate collection activity, and maintain filing of correspondence for future retrieval.
• Prepare and post any necessary adjustments/claim changes on accounts through the system based on the follow-up to expedite the collection process and to ensure the accuracy of the account daily.
• Confer with payers to determine the reason for unpaid balances and to obtain payment commitments.
• Review assigned accounts, process the debit/credit adjustments, rebill the account to payers and systematically move monies back to the insurance or patient bucket and appropriate next action.
• Analyze and calculate the payment and contractual amounts on remittances received from payers. Includes denied claims to ensure that patients are billed appropriately.
• Request refunds or retractions as appropriate.
• Pull medical record or request medical record from Health Information Management for suspended claims in a timely manner.
• Regular and timely attendance.
• Other duties as assigned.

Qualifications and Requirements

• At least 1 year of experience in Hospital Billing, Follow-Up or Collections
• Must have a good understanding of reimbursement methodologies and terms.
• Must understand commercial & government payer billing requirements.
• Must have demonstrated knowledge of industry trends in Managed Care.
• Work requires familiarity working with third-party contracts and payment rules.
• Must have demonstrated expertise in insurance, managed care and federal/state coverage.
• Work requires a high level of problem-solving skills.
• Able to work independently, identify patterns, make informed decisions, correctly identify root causes to determine appropriate actions and outcomes.
• Work requires the ability to ensure the confidentiality and rights of patients and the rights of patients and the confidentiality of hospital and departmental documents.
• Must be able to demonstrate a working knowledge of personal computers and other standard office equipment.
• Must demonstrate a positive demeanor, good verbal and written communication skills and be professional in both appearance and approach.
• Must be able to handle potentially stressful situations and multiple tasks simultaneously.
• Remote and hybrid positions require home internet connections that meet the company's upload and download speed criteria.

Benefits

ElevatePFS believes in making a positive impact not only within our industry but also with our employees the organization's greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.

• Medical, Dental & Vision Insurance
• 401K (100% match for the first 3% & 50% match for the next 2%)
• 15 days of PTO
• 7 paid Holidays
• 2 Floating holidays
• 1 Elevate Day (floating holiday)
• Pet Insurance
• Employee referral bonus program
• Teamwork: We believe in teamwork and having fun together
• Career Growth: Gain great experience to promote to higher roles

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage. The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. ElevatePFS is an Equal Opportunity Employer.