Analyzes, researches and prepares the insurance claims to be submitted to insurance carriers on responsible section of accounts receivable, timely and accurately, guaranteeing early turnaround of accounts receivable and maximum collections.
Responds to all inquiries, billing denials, and other correspondence and phone requests in an efficient and effective manner.
Attach necessary documentation when mailing claims to payors.
Handle telephone inquiry, according to policy, on delinquent claims.
Involves the patient as allowable under contract.
Maintains excellent rapport with the customer in this process, maintain departmental and institutional policies and procedures.
Resolves problem accounts independently using sound judgement and following established policies and procedures in a timely manner while meeting established productivity goals.
Documents activity within client’s patient accounting system and EOS systems.
Continuing education in rules and regulations governing the processing of accounts receivable by respective financial class(s).
Maintains all reports, files, and records as needed in position.
Locates, photocopies, faxes, analyzes EOBs to determine appropriate reimbursement by insurance carriers.
Meets and maintains quality assurance standards as determined by management.
Works as patient account representative as needed.
Other duties may be assigned.

2 years of previous experience working with commercial or other third-party insurance claims, medical billing/follow-up
An understanding of various forms, codes (CPT & ICD), insurance terminology and insurance company remittance advice
EPIC experience preferred but not required
Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required

Medical Billing Specialist

About this role