Medical Billing Representative

Medical Billing Representative

FLSA Status: Non-Exempt

Classification: Full-Time

Reports To: Revenue Cycle Manager

Job Overview:
Account Manager will provide revenue cycle process including charge capture, claim submis- sion, payment posting, claim follow up and appeals to ensure efficient, timely and accurate pay- ment of accounts.

The Account Manager will have a team assigned (if applicable)to help with all processes that are necessary to meet the goals established and to ensure compliance with company policy and procedure.

The Account Manager is responsible for the account and will be in direct contact with the prac- tice.

Responsibilities and Duties:

• Ensure timely and accurate processing of claims; direct effort and/or coordination with the team.
• Submit claims and work rejections; determine root cause, resolve, advise on procedural changes to implement and prevent future rejections.
• Work denials or coordinate with the team to work denials; fix, resubmit or appeal in a timely fashion (within 7 days). Determine Root cause; advise on procedural changes to implement and prevent future denials.
• Reconcile payment posting using the bank deposit daily; post payments daily to the proper account; post denials using denial codes; compare EOB’s, checks and system reports for accuracy.
• Run AR reports; coordinate with the team to ensure all claims from 30 to 60 and 61 to 90 days have been worked. Accounts over 90 days need special assistance, review by payor.
• Email patient statements weekly ensuring all patients receive statements every month.
• Work Patient AR through auto process, responding via email or text.
• Assist patients with questions regarding insurance and account balances.
• Proactively communicate with the client on all areas that will positively impact or nega- tively impact reimbursement.

Skills and Competencies:

• Accounts receivable process knowledge/experience
• Knowledge of Medicare, Medicaid, HMO/PPO, Tricare, commercial insurance operating procedures; medical terminology
• Demonstrate good judgement in selecting methods and techniques for obtaining solu- tions.
• Detail Orientated with proven organizational and problem-solving skills.
• Strong understanding of professional claims invoicing practices such as CMS 1500 and

EDI (Electronic Data Interchange)

• Ability to multitask efficiently and effectively
• Ability to work with a team setting.
• Strong communication skills

Requirements/Qualifications:

Some positions may require a certain level of education, related work experience, knowledge, skills, abilities, licensures, certification and/or other job-related requirements.

• Must have a thorough knowledge of billing and payer collections (commercial and gov- ernment)
• Have a thorough understanding of the revenue cycle process
• Demonstrated ability to work independently, take initiative and be self-motivated
• Expert in clearinghouse rejections
• High School graduate or equivalent
• Certified Coder preferred, but not required
• 3 – 5 years Medical billing experience

This description is intended to provide only basic guidelines for meeting job requirements. Responsi- bilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Job Type: Full-time

Pay: From $37,400.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Remote

Experience:

• Medical billing: 2 years (Required)

Work Location: Remote