Medical Biller

» Medical Biller
Healthcare
in Maitland
, FL
Reference: 19-02041

Description:

  • Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
  • Under general supervision, is responsible for processing insurance and billing insurance in a timely manner

Responsibilities:

  • Adheres to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies
  • Works with Insurance payers to ensure proper reimbursement on patient accounts
  • Depending on payer contract may be required to participate in conference calls, accounts receivable reports, compiles the issue report in order to expedite resolution of accounts
  • Examines contract to ensure proper reimbursement, educates team of inconsistencies in processing, including disciplinary discussions if necessary, and any changes to contract identified
  • Works follow up report daily, maintaining established goal(s), and notifies Supervisor, of issues preventing achievement of such goal(s)
  • Follows up on daily correspondence (denials, underpayments) to appropriately work Patient accounts
  • Assists Customer Service with Patient concerns/questions to ensure prompt and accurate resolution is achieved
  • Produces written correspondence to payors and patients regarding status of claim, requesting additional information, etc.
  • Reviews previous account documentation, determining appropriate action(s) necessary to resolve each assigned account
  • Initiates next billing, follow-up and/or collection step(s), this is not limited to calling patients, insurers or employers, as appropriate
  • Sends initial or secondary bills to Insurance companies
  • Documents billing, follow-up and/or collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary
  • Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims
  • Remains in consistent daily communication with Team members, including new process education, disciplinary actions, Reimbursement Lead and Reimbursement Manager regarding all aspects of assigned projects
  • Monitors and assists team members regularly, providing feedback, ensuring both goals and job requirements are met as assigned by Manager
  • Trains new staff, performs audits of work performed, and communicates progress to appropriate Supervisor
  • Provides continuing education of all team members on process and A/R requirements
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account

Knowledge and Skills Required:

  • Ability to use discretion when discussing personnel/patient related issues that are confidential in nature
  • Ability to be responsive to ever-changing matrix of hospital needs and act accordingly
  • Typing skills equal to 20 words per minute net
  • Proficiency in performance of basic math functions
  • Ability to communicate professionally and effectively in English, both verbally and in writing
  • Proficiency in Microsoft office products such as Word and Excel
  • Strong analytical and research skills

Education and Experience Required:

  • 1 year experience in Revenue Cycle Department or related area (registration, finance, collections, customer service, medical, contract management)

Education and Experience Preferred:

  • High school diploma or GED