What are the responsibilities and job description for the Medicare/Medicaid Biller position at TOWN & COUNTRY DRUG STORE INC?
Job Summary:
We are seeking a detail-oriented and knowledgeable individual to join our team as a Medicare/Medicaid/3rd Party Insurance Biller. The Medicare/Medicaid Biller is responsible for preparing and submitting claims to Medicare, Medicaid, and other government payers. This position ensures accurate billing, follows up on unpaid claims, and resolves billing issues in compliance with federal and state regulations.
Key Responsibilities:
- Prepare, review, and submit medical claims to Medicare, Medicaid, and other third-party government payers. These may include pharmacy medical equipment including but not limited to nebulizers, canes/walkers, diapers/pads/etc, wipes, diabetic supplies, ostomy supplies and more.
- Ensure claims are submitted accurately and in a timely manner to avoid denials or delays in reimbursement.
- Verify patient eligibility and coverage prior to billing.
- Review remittance advice to identify denials or payment discrepancies and take appropriate follow-up action.
- Appeal denied or underpaid claims according to payer guidelines.
- Monitor accounts receivable and follow up on unpaid balances.
- Maintain knowledge of billing regulations and compliance guidelines for Medicare and Medicaid.
- Work with healthcare providers, insurance companies, and patients to resolve billing issues.
- Keep detailed documentation of all billing activities and communications.
- Utilize billing software and electronic health record (EHR) systems.
Qualifications:
- High school diploma or equivalent; associate degree or certification in medical billing/coding preferred but not required.
- Familiarity with HIPAA regulations and medical terminology.
- Excellent organizational, analytical, and communication skills.
- Ability to work independently and as part of a team.
- Knowledge of commercial insurance billing is a plus.