Primary Responsibilities/Requirements:

• Answer billing calls from patients and assist with account resolution
• Reviews patient bills for accuracy and completeness and obtains any missing information.
• Verifies correct coding/charge entry to ensure prompt payment.
• Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing.
• Follows up on unpaid claims within standard billing cycle timeframe.
• Checks each payment for accuracy and compliance.
• Calls insurance companies regarding any discrepancy in payment, if necessary.
• Identifies and bills secondary or tertiary insurances.
• Follows up with the referral source to obtain necessary paperwork as required by Insurance.
• Works with Medicaid, Medicare, and various commercial insurers for billing and collection purposes.
• Ability to master the EMR/PM systems.
• Ability to utilize software applications to process claims, research statements, and research accounts.
• Process claims, referrals, crossovers, and authorizations
• Responsible for filing appeals and following them through the process of payment
• Work AR work list as assigned
• Print records requested for proper claims processing

Must Also Posses:

• Ability to communicate well with patients, physicians, and staff
• Self-motivated and ability to work independently
• Positive “teamwork” attitude
• Assist with other duties as assigned

Education and Experience:

• Two years of experience in clerical/office support work and/or education at the high school level
• Minimum of two years billing experience - preferred
• Minimum: DME experience required, two years AR experience required
• Knowledge of Insurance guidelines and other payment requirements
• Knowledge of ICD 10 Codes
• Knowledge of HCPCS Codes
• Knowledge of LCD’s
• CPC/CPC-A encouraged but not required

Experience

• 2 year(s): AR Experience