MEDICAL BILLER

Medical Claims Specialist

Pay Range: $17.54hr - $22.54hr

Requirement/Must Have:

• 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.
• Strong verbal and written communication skills.

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.
• Monitor insurance carrier adjudication of 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.

Nice to Have:

• 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.

Skills:

• Medical Billing.
• Medical Coding.
• Electronic Health Records (EHR).
• Clearing House Operations.
• Claim Adjudication.
• Aging Reports.
• Insurance Carrier Portals.

Qualification And Education:

• High school diploma.