Medical Billing Specialist

Job Description

Job Description

Title: Medical Billing Specialist
Location: Mason OH, 45040 - Hybrid 3 Days in Office
Contract: 4 Months and Temp to perm
Work hours: First Shift – 8 AM – 5 PM
Pay Rate: $22.55/hr

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

General Function:
The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of Client 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.

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.

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