Medical Billing Representative

Job Purpose

The Medical Billing Representative posts payments received from insurance companies, cash payments, and payment plans to the patient's accounts; enters adjustments, write-offs, and reconciles the patient’s accounts.

The Medical Billing Representative reviews claims for non- payment, posts the zero payment to the patient’s account and writes off the unpaid procedures and claims; resubmits claims with corrected codes, submits secondary claims, and mails statements for co-pays and balances due on the account.

The Billing Specialist works reports, processes refunds and check requests; does account clean up, and serves as a resource to the medical practices to help improve billing processes and accuracy. Calls resident physicians for confirmation.  

Specific Duties and Responsibilities :

The following are the specific duties and responsibilities of the Medical Billing Representative:

• Post cash payments, primary & secondary insurance payments, and Payment Plans
• Appeal denied services to insurance agencies.
• Write-off unpaid claims
• Mail Secondary Claims
• Mail Statements for Co-pays and Patient Balances
• Clean-up accounts
• Process Insurance Refund Requests for an overpayment
• Process Check Refund Requests from Patients work weekly reports.
• Assists medical offices with any patient/insurance payment questions.
• Achieve departmental goals for accurately submitting both paper and electronic.
• Insurance claims for the previous day’s treatment
• Verify all demographic (spelling of names, date of birth, and the insurance carrier) information is correct.
• Correct insurance and demographic information if incorrect and resubmit a corrected claim within 95 days from DOS.
• Adheres to company, department, corporate, personnel and standard policies and Procedures.
• Attend all mandatory company in-services and staff development activities as scheduled.
• Adhere to company standards concerning conduct, dress, attendance, and Punctuality.
• Support company-wide quality/performance improvement goals and objectives
• Maintain confidentiality of company employees and patient information
• Perform other duties as assigned.
• Provide support as an Administrative Assistant
• Communicating with clients via phone and email
• Entering Data into the client system
• Submission of claims, EOBs, and other pertinent billing documents
• Resolve client and billing issues with client team.
• Accessing data points in client tools
• Modifying, emailing and faxing documents

Requirements

• Bachelor’s degree in business, health care administration, accounting or relevant field is recommended.
• A minimum of 1 year experience as a medical biller or similar role.
• Must have the ability to multitask and manage time effectively.
• Excellent written and verbal communication skills.
• Outstanding problem-solving and organizational abilities.
• Senior Level EP