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Medical Biller
Exceptional HR Solutions, LLCMedical Biller ensuring accurate claim processing for Ideal Option, a leading opioid treatment provider. Collaborating with insurance companies and patients to facilitate billing processes and compliance.
About the role
Key responsibilities & impact- Submitting medical claims to insurance companies and payers such as Medicare and Medicaid.
- Works directly with the insurance companies, healthcare providers and patients to get a claim processed and paid.
- Reviews and appeals unpaid and denied claims.
- Processes patient and insurance refund requests in a timely manner and posts payments and/or denials from insurance remits.
- Assists patients in getting the correct information to apply for charity/Medicaid or a payment plan.
- Uses coded data to produce sub claims to insurance companies.
- Maintains knowledge of current billing rules and trends for billing types assigned.
- Assists patients in verifying benefit information and assists in patient scheduling and account creation.
- Ensures weekly, monthly, and quarterly department goals are met.
- Obtains referrals and pre-authorizations as required for procedures.
- Checks eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Reviews patient bills for accuracy and completeness and obtaining any missing information.
- 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 insurance payment for accuracy and compliance with contract discount.
- Calls insurance companies regarding any discrepancy in payments if necessary.
- Identifies any billing secondary or tertiary insurances.
- Sets up patient payment plans and work collection accounts.
- Updates billing software with rate changes.
- Must comply with all elements within HIPAA and the Privacy Act.
Requirements
What you’ll need- A minimum of one-year experience with medical billing
- High School Diploma or GED.
- Proficiency with Microsoft Office Suite and Internet.
- A knowledge of chemical dependency and its effects on individuals, families, and communities is preferred.
Benefits
Comp & perks- Medical, vision, and dental
- Short-term and long-term disability options
- Life insurance
- Employee Assistance and Life Assistance programs
- A 401K retirement program
- Pet Insurance
- Paid time off and paid holidays
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical billingclaims processingclaims reviewpayment postingbenefit verificationbilling softwareelectronic claim processingreferrals and pre-authorizationsaccount creationpayment plans
Soft Skills
communicationorganizational skillsattention to detailproblem-solvingcustomer service
Certifications
High School DiplomaGED