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