Under the supervision of the Medical Billing Coordinator; responsibilities include initiating contracts and invoicing, billing and/or following up on insurance claims, and general office support.
- Reviews medical claims and occupational health and grant invoices for data accuracy, appropriate coding, ensures timely claim submission to insurance companies on paper and/or EDI, and ensures that the third party contractual agreements are met.
- Verifies the accuracy of medical claims and processes claims in a timely manner to receive accurate reimbursement. Must comply with all federal, state, and payor requirements for all North Country HealthCare clinics.
- Liaison for lab invoicing.
- Researches, records findings, and communicates effectively with Supervisor and Manager to achieve optimum performance.
- Responsible for timely EOB Denial follow up.
- Performs follow up with insurance companies on rejections generated from electronic claim submissions, as well as following up on unpaid insurance accounts identified through aging reports. Identifies and reports trends and issues relating to billing and reimbursements to Supervisor or Manager.
- Basic computer skills.
- Word and Excel knowledge required.
- Team player with the ability to multitask.
- One year of medical billing experience preferred.
- Certified Professional Coder preferred.
- Knowledge of medical terminology preferred.
- Knowledge of CPT/CDT and/or ICD-10 coding preferred.
- Verbal and written communication skills with the ability to professionally and effectively exchange and convey information.
- Establish and maintain acceptable working relationships with employees, other agencies, and the public.