Job Description
Position Overview
ProHealth One is seeking a detail-oriented, organized Full Cycle Medical Biller to join our team. This position will be focusing on posting payments, AR clean up, printing and mailing statements, eligibility, denials, and more. This person will be someone who has strong interpersonal and communication skills and strives for accuracy and efficiency.
Duties and Responsibilities
Check insurance eligibility
Follow up on unpaid claims within standard billing cycle timeframe.
Check each insurance payment for accuracy and compliance with contract discount.
Call insurance companies regarding any discrepancy in payments if necessary
Identify and bill secondary or tertiary insurances.
Review accounts for insurance of patient follow-up.
Research and appeal denied claims
Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
AR clean up
Denial and appeal management
Insurance eligibility
Collecting patient payments and sending out patient statements
Set up patient payment plans and work collection accounts.
Review file rejections at clearinghouse level and in billing bins. Refile claims as needed.
Completing clearing house paperwork
Fax correspondence to insurance companies in a timely manner.
Accept credit card payments over the phone from patients
Call patients to update address upon returned mail.
Post adjustments, payment entry, charge entry as needed for EOBs ERAs, etc.
Maintaining accurate revenue from patient payments and insurance reimbursements
Work correspondence received by mail and scan to google drive.
Handle refunds to patients or insurance companies as needed.
Enter insurance companies in system when necessary.
Participate in conference calls with regards to billing department.
Assist in training of new staff.
Utilize insurance websites and portals for claim refiles, follow up, eligibility, etc.
Assist with other functions of the office as necessary.
Requirements and Qualifications A minimum of two to three years of experience in a medical office setting and 2 year of Billing, Posting, and AR follow up work.
Must have insurance reimbursement knowledge
Extensive knowledge of medical billing and collection practices.
Understanding of medical and billing terminology.
Must have experience with PC based business applications software such as Microsoft Office, Word and Excel.
Must have a High school diploma or GED.
Proper English grammar, usage, spelling and punctuation: modern business office procedures, including filing systems, business correspondence, and telephone techniques.
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems. Ability to operate standard office machines and equipment, including telephones, computers, copy machines, fax machines, calculators, scanners and shredders
Excellent communication skills for both phone contacts with insurance payers to resolve issues as well through correspondence with various companies.
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. A calm manner and patience working with either patients or insurers during this process.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Ability to multitask.