Medical Billing Specialist

GENERAL FUNCTION

The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearinghouse to review and submit claims to multiple medical insurance carriers. Review open/unpaid claim balances and take required action.

MAJOR DUTIES & RESPONSIBILITIES

· Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.

· Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.

· Download insurance carrier explanation of payments (EOPs) to post claim payments and denials in the EHR system.

· Determine if denied claims can be corrected and re-submitted to the carrier.

· Review aging reports to research open balances and resubmit within insurance carrier filing limits.

· Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.

· Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.

· Initiate overpayment refunds to patients and repayments to insurance carriers when required.

· Serve as the point of contact for the practice regarding all vision and medical claims.

· Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS

· High school diploma

· 3 years of related work experience

· Experience with medical billing and coding

· Ability to prioritize handling of issues

· Organization skills and ability to multitask

· Effective communication skills (verbal, written, listening, presentation)

PREFERRED QUALIFICATIONS

· Experience working in multiple doctor practices

· Experience working with multiple insurance carriers and an understanding of their claim requirements

· Proven ability to identify issues and solve problems

Pay: $20.00 - $21.00 per hour

Benefits:

• Health insurance

Work Location: Hybrid remote in Mason, OH 45040

Salary : $20 - $21