Valid City, State or Zip Code:
Fresno
Job Type :
Permanent
Date:
Sunday, 10 November 2019
Medical Billing / Accounts Receivable
Summary:
The main function of a medical biller is to submit medical claims to insurance companies and payers such as Medicare and Medicaid.
Responsible for the timely submission of technical or professional medical claims to insurance companies.
The position may be located in physician offices, hospitals, nursing homes, or other healthcare facilities.
Job Responsibilities:
Obtain referrals and pre-authorizations as required for procedures
Check eligibility and benefit verification
Review patient bills for accuracy and completeness and obtain any missing information Prepare, review, and transmit claims using billing software, including electronic and paper claim processing Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid 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
All accounts are to be reviewed for insurance or patient follow-up Research and appeal denied claims
Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
Set up patient payment plans and work collection accounts
Update billing software with rate changes Updates cash spreadsheet, runs collection reports
Skills:
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Use of computer systems, software, 10 key calculator Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
Able to work in a team environment Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Knowledge of accounting and bookkeeping procedures
Knowledge of medical terminology likely to be encountered in medical claims
Education/Experience:
High school diploma Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred 2 to 4 years of experience.
Required Skills
Strong organizational skills and attention to detail
Excellent written and verbal communication skills
Ability to work independently with minimal direction and oversight as well as with a team
Ability to handle multiple responsibilities under strict deadlines and prioritize efficiently
Minimum of three years' revenue cycle experience and knowledgeable on insurance billing, collections and reimbursement processes
Ability to navigate through the field locators on the UB 04 confidently and by able look up various field requirements such as modifier, occurrence codes, ICD 10 diagnosis and CPT treatment codes from online services or using traditional coding references
Familiarity with HIPAA privacy guidelines and maintains and protects all confidential information
Familiarity with payer specific items such as HCPCS, addresses, special billing requirements such as attachments and carve outs.