Medical Biller- Tnt Healthcare Billing Solutions

Position Overview:

Your responsibilities will include reviewing medical documentation, coding procedures, generating claims, submitting claims to insurance companies, following up on claim statuses, and ensuring timely reimbursement. This position requires strong knowledge of medical billing procedures, coding systems, and insurance regulations, as well as excellent attention to detail and communication skills.

Responsibilities:

Medical Billing and Coding:

• Review medical documentation and accurately assign appropriate codes using ICD-10, CPT, and HCPCS code sets.

• Ensure coding compliance with industry standards, payer guidelines, and regulatory requirements.

• Verify and update patient demographic and insurance information as necessary.

Claim Generation and Submission:

• Generate accurate and complete claims based on coded information.

• Submit claims electronically or by paper according to payer requirements.

• Validate claim information, including patient and provider details, services rendered, and billed amounts.

Claim Follow-Up and Resolution:

• Monitor and track claim submissions to insurance companies.

• Follow up on unpaid or denied claims, investigating reasons for denials or rejections.

• Take necessary actions to resolve claim issues, including submitting appeals, correcting errors, or resubmitting claims.

Payment Posting and Reconciliation:

• Accurately post payments and adjustments received from insurance companies, patients, and other payers.

• Identify and resolve payment discrepancies, including overpayments, underpayments, and non-payments.

• Reconcile accounts receivable balances and ensure accuracy of financial records.

Insurance and Patient Communication:

• Communicate with insurance companies to verify coverage, resolve claim issues, and obtain necessary information.

• Interact with patients to address billing inquiries, explain charges, and assist with payment arrangements.

• Provide clear and concise explanations of insurance benefits, patient responsibilities, and payment options.

Documentation and Reporting:

• Maintain accurate and organized records of billing activities, claim status, and payment history.

• Generate reports on billing and reimbursement metrics, identifying trends, issues, and opportunities for improvement.

• Adhere to confidentiality and privacy regulations in handling sensitive patient and billing information.

Compliance and Quality Assurance:

• Stay updated on industry changes, regulatory guidelines, and insurance policies related to medical billing.

• Ensure compliance with coding and billing regulations, including HIPAA and relevant billing standards.

• Participate in internal quality assurance activities to maintain accuracy and adherence to best practices.

Qualifications:

• 
  High school diploma or equivalent; additional certification in medical billing or coding is preferred.

• Proven experience as a Medical Biller or in a similar role.

• Strong knowledge of medical billing procedures, coding systems (ICD-10, CPT, HCPCS), and insurance regulations.

• Proficiency in medical billing software and electronic health record (EHR) systems.

• Excellent attention to detail, with the ability to accurately review and analyze medical documentation.

• Strong communication skills, both written and verbal, with the ability to interact professionally with insurance companies, providers, and patients.

• Ability to work independently and meet deadlines in a fast-paced environment.

• Problem-solving skills, with the ability to identify and resolve claim-related issues.

• Familiarity with medical terminology and Healthcare Billing practices.