Optimum RTS - Medical Biller
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Medical Biller

Location : Greenacres, FL
Job Type : Direct
Hours : Full Time
Required Years of Experience : 2
Travel : No
Relocation : No
Job Industry : Medical Office
Job Category : Medical Office

Job 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!


Required Qualifications :

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

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