Job Description
Position Summary: Our growing office is seeking an experienced Medical Biller to work in our Billing Office. This position requires fundamental knowledge in denial management, resolving claims with no response, and knowledge on how insurance companies pay accordingly to contracts. The candidate will know how to read and interrupt an insurance explanation of benefits (EOB) and do precise A/R follow-up with the insurance company via, phone, email, insurance websites, etc. at an acceptable volume per day.
Qualifications:
- Minimum three years of behavioral health experience required.
- High School diploma or equivalent required.
- Experience with claim denials required.
- Insurance verification required.
Essential Functions:
- Denial Management knowledge
- Initiate correction on all claims with errors/denials
- Completes precise follow-up of insurance aging claims with no response as well as denied claims
- Familiar with payer rules and regulations
- Specialist will complete and review accounts that may have a credit balance and resolve the account
- May post payments from the different payers to patient’s accounts when applicable
- Assure that the collection of deposits and co-pays when applicable
- Enters relevant information into the computer system
- Sets up payment arrangements with self-pay patients
- Assists patients and staff with questions concerning their insurance coverage
- Participates in data gathering for financial reporting
- Be willing to serve as a communications person between the department and insurance companies, payer reps, other members of our organization
Knowledge, Skills, and Abilities
- Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude
- Must be able to read and interpret an EOB
- Knowledge of medical insurances (Medicare, HMO’s, PPO’s, commercial, MCO’s Medicaid) regulations, physician billing and collection process
- Must have excellent customer service and communication skills
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Application Question(s):
- Can you explain the difference between ICD, CPT, and HCPCS codes?
- Walk me through the medical billing process from patient registration to payment posting.
- How do you handle denied claims?
- How do you handle COBs? Do you know what a COB is?
- Are you familiar with Medicare and Medicaid billing?
Education:
- High school or equivalent (Required)
Experience:
- claim denials: 1 year (Required)
- Insurance verification: 1 year (Required)
- Behavioral health: 3 years (Required)
Work Location: In person
