Medical Biller

Description

We are looking for a knowledgeable, biller and coder. ATHENA experience preferred. The ideal candidate will have a minimum of 2 years of medical billing experience in a medical office setting. Candidates with CPC or CPB preferred. Must be able to work in the office. Bilingual a plus!

Must be skilled in the following:

• Post insurance and patients' payments.


• Reviews claim prior to submitting to the insurance carriers


• Answer patient inquiries on account status and charges


• Obtain patient payments


• Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate


• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form


• Answer patient questions on patient responsible portions, copays, deductibles, write-off’s, etc. Resolves patient complaints or explains why certain services are not covered.


• Prepares patient statements for charges not covered by insurance. Insures statements are mailed on a regular basis.


• Work with patients to establish payment plan for past due accounts in accordance with provider policies.


• Posts insurance and patient payments


• May perform “soft” collections for patient past due accounts


• Prepares and submits secondary claims upon processing by primary insurer as needed


• Follows HIPAA guidelines in handling patient information.


• Understands managed care authorizations and limits to coverage such as the number of visits.


• Verify patient benefits eligibility and coverage at times.


• Follows standard billing procedures


• CPT and ICD-10 coding rules and guidelines


• Claim denials


• Deductible/Co-insurance determination


• Un-postables


• Familiarity with the claim processes of commercial payers


• Fundamentals of Coding