Medical Billing Associate III

Medical Billing Associate III

The Medical Billing Associate III will be responsible for managing patient billing data, insurance verification, claims processing, and payment tracking. This role ensures accuracy of patient records, compliance with healthcare billing regulations, and timely resolution of billing discrepancies while maintaining high standards of confidentiality and customer service.

Requirement/Must Have:

• Strong knowledge of medical billing processes and healthcare administrative procedures.
• Understanding of insurance verification, authorizations, and patient benefits.
• Familiarity with Medicare, state programs, and HMO/PPO guidelines.
• Strong communication skills for handling patient and insurance inquiries.
• Ability to manage billing records and maintain accurate documentation.
• Strong problem-solving and analytical skills.
• Ability to work independently and manage multiple priorities.

Experience:

• High school diploma or equivalent required.
• Bachelor’s degree in Accounting, Healthcare Administration, Finance, Business, or related field preferred.
• Previous experience in medical billing or healthcare administrative roles preferred.
• Experience working with billing software preferred.

Responsibilities:

• Ensure patient information is accurate and complete; request missing information as needed.
• Review referrals and insurance authorizations.
• Confirm patient insurance benefits and coverage details.
• Ensure compliance with Medicare, state programs, and HMO/PPO regulations.
• Transfer insurance claims and billing data into billing systems.
• Create and maintain both paper and electronic documentation.
• Develop and maintain tracking systems for incoming and late payments.
• Monitor overdue payments and initiate follow-up notices.
• Respond to patient and insurance company inquiries and complaints.
• Follow up on missed or late payments and resolve billing issues.
• Identify and resolve financial discrepancies.
• Arrange payment plans and schedules when required.
• Maintain organized billing records and documentation.
• Update and review accounts to ensure accurate payment records.
• Maintain patient confidentiality at all times.

Should Have:

• Strong customer service and interpersonal skills.
• Excellent time management and organizational abilities.
• Ability to work independently with minimal supervision.
• Ability to analyze issues and propose effective solutions.

Skills:

• Medical billing and claims processing.
• Insurance verification and authorization handling.
• Healthcare compliance and regulations.
• Billing software (preferred).
• Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
• Data entry and record management.
• Customer service and communication skills.
• Financial tracking and discrepancy resolution.