Efficient Healthcare Claims Processor
2 weeks ago
We are seeking a skilled Medical Biller to join our team. The successful candidate will be responsible for posting medical charges, payments, and journal entries to patient accounts in a timely and accurate manner.
Main Responsibilities
- Work directly with insurance companies, healthcare providers, and patients to process claims efficiently.
- Verify correct insurance filing information and notify clients of potential coding issues.
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
- Follow up on unpaid claims within the standard billing cycle time frame.
- Research and appeal denied claims.
- Meet individual and departmental standards with regard to quality and productivity.
- Able to handle protected health information in accordance with HIPAA regulations.
- Check eligibility and benefit verification.
Required Skills and Qualifications
- Possess knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid.
- Skilled in performing eligibility verification and precertification through web or verbal communication with insurance companies.
- Proficient in reading superbills and making charge entries in practice management systems.
- Familiarity with Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB) from various systems and websites is an advantage.
- Demonstrated credentialing and denial management skills are desirable.
Benefits
The ideal candidate will possess excellent communication and organizational skills, and be able to work effectively in a fast-paced environment.
Additional Requirements
- Possess strong analytical and problem-solving skills.
- Ability to work well under pressure and meet deadlines.
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