We are looking for a team member with a minimum of five years of high dollar billing experience to join our organization. This person will be a full-time, goal-oriented, revenue-driven, highly accurate and motivated Biller. Primary duties include, but are not limited to: consistently follow up on unpaid claims utilizing monthly aging reports, filing appeals when appropriate to obtain maximum reimbursement and establish and maintain strong relationships with providers, clients, patients and fellow staff. Secondary duties include but are not limited to pre-certification of surgical and diagnostic procedures, posting surgical procedures, Insurance Verification.
- Experience in CPT and ICD-10 coding; familiarity with medical terminology.
- Excellent customer service skills.
- Strong written and verbal communication skills.
- Team Player
- Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
- Neat appearance; pleasant speaking voice and demeanor; positive attitude.
- Responsible use of confidential information.
- Perform to company standards of compliance with policies and procedures.
- Ability to multi-task and work courteously and respectfully with fellow employees, clients and patients.
- Computer experience is essential, including, but not limited to: practice management software, word processing and spreadsheet applications, with a minimum of 40 wpm typing speed and 10-key by touch.
Detailed Work Activities
- Timely follow up on insurance claim denials.
- Bill patients for co-pays, co-insurances, and deductibles.
- Work on A/R High Dollar accounts.
- Insurance verification for IN-NETWORK & OUT of NETWORK plans.
- Write appeal letters on rejected claims.
- Able to read Operative Reports to assist in compiling an appeal letter.
- Knowledge on how to submit Corrected Claims for each carrier.
- Obtain authorizations and pre-certification on surgical and diagnostic services.
- Assists patients with questions or problems regarding insurance coverage and other financial matters.
- Prepares accounts for monthly referral to collection agency for all professional fee accounts.
- Establishes payment plans to help patients manage payment of bills
- Reviews all necessary edits to ensure coding compliance.
- Respond to inquiries from insurance companies, patients and providers.
- Ensure all claims are submitted with a goal of zero errors.
- Verifies completeness and accuracy of all claims prior to submission.
- Meet deadlines.
- Regularly meet with Billing Supervisor and or Practice Manager to discuss and resolve reimbursement issues or billing obstacles.
- Regularly attend monthly staff meetings and continuing educational sessions as requested.
- Perform additional duties as requested by Supervisory or Management team.
Required Education & Experience
- High School diploma or equivalent. Prefer Associates degree in Medical Billing and ICD-10 Coding.